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Meta‐analysis: ursodeoxycholic acid for primary sclerosing cholangitis
Author(s) -
Triantos C. K.,
Koukias N. M.,
Nikolopoulou V. N.,
Burroughs A. K.
Publication year - 2011
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2011.04822.x
Subject(s) - ursodeoxycholic acid , medicine , primary sclerosing cholangitis , gastroenterology , liver transplantation , placebo , clinical trial , randomized controlled trial , transplantation , pathology , alternative medicine , disease
Aliment Pharmacol Ther 2011; 34: 901–910 Summary Background There is no satisfactory medical treatment for patients with primary sclerosing cholangitis. There are conflicting data regarding the clinical benefit of high doses of ursodeoxycholic acid (UDCA) in primary sclerosing cholangitis. Aim To evaluate using meta‐analysis, if UDCA (standard or high‐dose) is useful in primary sclerosing cholangitis. Methods We searched MEDLINE using the textwords ‘PSC’, ‘treatment’, ‘UDCA’ and retrieved all abstracts from the major Gastroenterology and Liver meetings. We included randomised clinical trials comparing standard or high‐dose of UDCA (>15 mg/kg body weight per day) vs. placebo or no intervention. End‐points: mortality or liver transplantation, pruritus, fatigue, cholangiocarcinoma and histological progression. Results We identified eight randomised clinical trials comprising 567 patients. Five used standard doses and three high doses of UDCA. There was no significant difference in mortality [OR, 0.6 (95% CI, 0.4–1.4)], in pruritus [OR, 1.5 (95% CI, 0.3–7.2)], in fatigue [OR, 0.0 (95% CI, 0.1–7.7)], in cholangiocarcinoma [OR, 1.7 (95% CI, 0.6–5.1)] and in histology stage progression [OR, 0.9 (95% CI, 0.34–2.44)]. No differences were found in the subgroup analyses. Conclusion Neither standard nor high‐dose UDCA influence favourably the progression of primary sclerosing cholangitis.