Randomised controlled trials of ursodeoxycholic-acid therapy for primary biliary cirrhosis: a meta-analysis

@article{Goulis1999RandomisedCT,
  title={Randomised controlled trials of ursodeoxycholic-acid therapy for primary biliary cirrhosis: a meta-analysis},
  author={John Goulis and Gioacchino Leandro and Andrew K. Burroughs},
  journal={The Lancet},
  year={1999},
  volume={354},
  pages={1053-1060}
}

Urso—panacea or placebo?

BACKGROUND Ursodeoxycholic acid (UDCA) is the only approved treatment for primary biliary cirrhosis, but its effect on disease progression is uncertain. The aim of this study was to clarify the

Long-Term Effects of Mid-Dose Ursodeoxycholic Acid in Primary Biliary Cirrhosis: A Meta-analysis of Randomized Controlled Trials

Long-term treatment with mid-dose UDCA can improve liver biochemistry and survival free of liver transplantation in patients with PBC, and can delay the histological progression in the early-stage patients.

Ursodeoxycholic Acid for Patients With Primary Biliary Cirrhosis: An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials Using Bayesian Approach as Sensitivity Analyses

This updated systematic review did not demonstrate any benefit of UDCA on mortality and mortality or liver transplantation in patients with PBC, and meta-regression analyses suggested that UDCA effects seem to be associated with patient's disease severity and trial duration.

Ursodeoxycholic acid for primary biliary cirrhosis: final results of a 12-year, prospective, randomized, controlled trial

UDCA was not found to have any demonstrable effect on the long-term outcome of PBC and did not improve the survival of patients with primary biliary cirrhosis.

Ursodeoxycholic acid for primary biliary cirrhosis.

The random-effects model meta-regression showed that the risk of bias of the trials, disease severity of patients at entry, ursodeoxycholic acid dosage, and trial duration were not significantly associated with the intervention effects on all-cause mortality, or on all thecause mortality or liver transplantation.

A preliminary trial of high-dose ursodeoxycholic acid in primary sclerosing cholangitis.

High-dose UDCA may be of clinical benefit in PSC, but trials with a larger number of participants and of longer duration are required to establish whether the effect of high- dose UDCA on liver biochemistry, histology, and cholangiography in patients with PSC is translated into improved long-term survival.

A randomized controlled trial of colchicine plus ursodiol versus methotrexate plus ursodiol in primary biliary cirrhosis: Ten‐year results

Neither colchcine plus UDCA nor methotrexateplus UDCA improved survival beyond that predicted by the Mayo prognostic model, however, clinical, histologic, and biochemical improvement observed among those who remained in the study for 10 years suggests a possible benefit of these drugs in a subset of patients.

Therapy of Primary Biliary Cirrhosis: Novel Approaches for Patients with Suboptimal Response to Ursodeoxycholic Acid

The combined treatment of UDCA and fibrates in patients without optimal biochemical response to UDCA improves the degree of cholestasis and may minimize the long-term management of these patients.

Prognosis of Ursodeoxycholic Acid-Treated Patients with Primary Biliary Cirrhosis. Results of a 10-Yr Cohort Study Involving 297 Patients

A 10-year prognosis for most UDCA-treated patients with PBC is comparable to that of a matched general population, and the finding that observed survival was significantly better than predicted by the Mayo model may suggest that this model did not accurately predict prognosis in this cohort.
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References

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Ursodeoxycholic therapy in chronic liver disease: a meta-analysis in primary biliary cirrhosis and in chronic hepatitis.

MA confirmed a beneficial effect of UDCA in PBC on liver tests, histology, and treatment failure, and in CH, there was an improvement in liver Tests, but the evidence for histologic effect was sparse and insignificant.

A multicenter, controlled trial of ursodiol for the treatment of primary biliary cirrhosis. UDCA-PBC Study Group.

Ursodiol is a safe and effective treatment for primary biliary cirrhosis and follow-up analysis of 95 liver-biopsy specimens showed a significant improvement in the mean histologic score and in all the characteristic histologic features except fibrosis only in the group given ursodiol.

Ursodeoxycholic acid treatment in patients with primary biliary cirrhosis. A Swedish multicentre, double-blind, randomized controlled study.

UDCA improved serum enzyme values but not survival, symptoms, serum bilirubin levels, or liver histology, and there was no significant difference in response between initially symptomatic and asymptomatic patients.

Ursodiol for the long-term treatment of primary biliary cirrhosis. The UDCA-PBC Study Group.

Long-term ursodiol therapy slows the progression of primary biliary cirrhosis and reduces the need for liver transplantation.

Effects of ursodeoxycholic acid on survival in patients with primary biliary cirrhosis.

UDCA should be considered as a safe, effective, and life-extending treatment for patients with primary biliary cirrhosis.

Long‐term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis

In conclusion, long‐term UDCA therapy appeared to delay the development of cirrhosis in PBC.