Document Detail


Ursodeoxycholic acid: a second look. Primary biliary cirrhosis: dashed hopes.
MedLine Citation:
PMID:  12068838     Owner:  HSR     Status:  MEDLINE    
Abstract/OtherAbstract:
(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.
Authors:
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prescrire international     Volume:  11     ISSN:  1167-7422     ISO Abbreviation:  Prescrire Int     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-17     Completed Date:  2002-07-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9439295     Medline TA:  Prescrire Int     Country:  France    
Other Details:
Languages:  eng     Pagination:  67-9     Citation Subset:  T    
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MeSH Terms
Descriptor/Qualifier:
Cholagogues and Choleretics / 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:
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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