| Ursodeoxycholic acid: a second look. Primary biliary cirrhosis: dashed hopes. | |
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MedLine Citation:
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PMID: 12068838 Owner: HSR Status: MEDLINE |
Abstract/OtherAbstract:
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(1) In 1996 the evidence, though limited, suggested that the hydrophilic bile acid ursodeoxycholic acid slowed the progression of primary biliary cirrhosis. Given the absence of an effective alternative, we considered that the treatment was "A real advance" in this setting. (2) The file is far bulkier now. A meta-analysis of 11 randomised placebo-controlled trials of ursodeoxycholic acid in the treatment of primary biliary cirrhosis did not show efficacy. Histologically, the data suggest that the drug lowers the risk of hepatic fibrosis, but this is based on a low level of evidence. Moreover, there was no clinical improvement in the longest randomised trial (median follow-up 3.4 years). (3) Likewise, ursodeoxycholic acid seems to have a biochemical effect but no clear clinical effect in sclerosing cholangitis or in treating the hepatic complications of cystic fibrosis. (4) The main adverse effects are gastrointestinal disorders. (5) There are still no drugs clearly capable of slowing the clinical progression of primary biliary cirrhosis. Nevertheless, given the minor adverse effects of ursodeoxycholic acid, some patients may wish to gamble on a possible benefit in the very long term. (6) When primary biliary cirrhosis becomes symptomatic (with encephalopathy, osteomalacia, etc.) pending liver transplantation, treatment is aimed at controlling symptoms and preventing the rupture of oesophageal varices. |
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Authors:
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Prescrire international Volume: 11 ISSN: 1167-7422 ISO Abbreviation: Prescrire Int Publication Date: 2002 Jun |
Date Detail:
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Created Date: 2002-06-17 Completed Date: 2002-07-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9439295 Medline TA: Prescrire Int Country: France |
Other Details:
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Languages: eng Pagination: 67-9 Citation Subset: T |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cholagogues and Choleretics
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administration & dosage,
adverse effects,
therapeutic use Cholangitis / drug therapy Follow-Up Studies France Humans Liver Cirrhosis, Biliary / drug therapy* Meta-Analysis as Topic Product Surveillance, Postmarketing Randomized Controlled Trials as Topic Treatment Outcome Ursodeoxycholic Acid / administration & dosage, adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Cholagogues and Choleretics; 128-13-2/Ursodeoxycholic Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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