Ursodeoxycholic acid in the treatment of primary biliary cirrhosis.

@article{Lindor1994UrsodeoxycholicAI,
  title={Ursodeoxycholic acid in the treatment of primary biliary cirrhosis.},
  author={K. Lindor and E. Dickson and W. Baldus and R. Jorgensen and J. Ludwig and P. Murtaugh and J. M. Harrison and R. Wiesner and M. Anderson and S. Lange},
  journal={Gastroenterology},
  year={1994},
  volume={106 5},
  pages={
          1284-90
        }
}
BACKGROUND/AIMS A double-blind, placebo-controlled trial of ursodeoxycholic acid (UDCA) was conducted in 180 patients with primary biliary cirrhosis (PBC) to define the efficacy and safety of UDCA. Efficacy was assessed by time to treatment failure defined as death; liver transplantation; histological progression; development of varices, ascites, or encephalopathy; doubling of total serum bilirubin levels; progression of fatigue or pruritus; drug toxicity; or voluntary withdrawal. METHODS… Expand
Treatment With Ursodeoxycholic Acid Is Associated With Weight Gain in Patients With Primary Biliary Cirrhosis
TLDR
UDCA treatment in patients with PBC is associated with a significant weight gain that occurs in the first 12 months of therapy, persists for the duration of treatment, and occurs independent of baseline BMI. Expand
A preliminary trial of high-dose ursodeoxycholic acid in primary sclerosing cholangitis.
TLDR
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. Expand
Ursodeoxycholic acid treatment in patients with primary biliary cirrhosis. A Swedish multicentre, double-blind, randomized controlled study.
TLDR
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. Expand
Long-term effects of ursodeoxycholic acid in primary biliary cirrhosis: results of a double-blind controlled multicentric trial
TLDR
Although UDCA treatment did not significantly affect time to death or liver transplantation and to clinical complications, the effects on both cholestasis and liver histology suggest that UDCA is safe and may be useful for preventing the progression of primary biliary cirrhosis. Expand
Ursodiol for Primary Sclerosing Cholangitis
TLDR
Ursodiol (ursodeoxycholic acid) benefits patients with primary biliary cirrhosis, another cholestatic liver disease, and well-documented primary sclerosing cholangitis in a randomized, double-blind study comparing ursodiol with placebo. Expand
Methotrexate (MTX) plus ursodeoxycholic acid (UDCA) in the treatment of primary biliary cirrhosis
TLDR
In conclusion, methotrexate when added to UDCA for a median period of 7.6 years had no effect on the course of PBC treated with UDCA alone. Expand
Incomplete response to ursodeoxycholic acid in primary biliary cirrhosis: is a double dosage worthwhile?
TLDR
Although UDCA at a dose of 28–32 mg/kg/day is well tolerated, this dosage does not seem to benefit most patients with primary biliary cirrhosis responding incompletely to a doses of 13–15 mg/ kg/day. Expand
Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis.
TLDR
Long-term UDCA therapy appeared to delay the development of cirrhosis in PBC and a marked improvement in liver biochemistries and Mayo risk score was noted in all patients duringUDCA therapy; however, this improvement was not significantly different between patients who progressed and those who did not. Expand
Cost‐effectiveness of ursodeoxycholic acid therapy in primary biliary cirrhosis
TLDR
Compared with the placebo group, patients receiving UDCA had a lower incidence of major complications and lower medical care costs, and there was an annual cost savings per patient of $1,372. Expand
Results of long-term ursodiol treatment for patients with primary biliary cirrhosis
TLDR
UDCA appears to be of most benefit when instituted in early stage disease, and although a substantial percentage of patients will achieve biochemical normalization on UDCA alone, there is a continued need for therapeutic options for others who have less complete biochemical responses. Expand
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References

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Effects of ursodeoxycholic acid on survival in patients with primary biliary cirrhosis.
TLDR
UDCA should be considered as a safe, effective, and life-extending treatment for patients with primary biliary cirrhosis. Expand
A multicenter, controlled trial of ursodiol for the treatment of primary biliary cirrhosis. UDCA-PBC Study Group.
TLDR
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. Expand
IS URSODEOXYCHOLIC ACID AN EFFECTIVE TREATMENT FOR PRIMARY BILIARY CIRRHOSIS?
TLDR
It is suggested that long-term UDCA might be a safe and effective treatment for PBC, but a randomised, controlled, double-blind trial is urgently needed. Expand
Ursodeoxycholic acid in primary biliary cirrhosis: results of a controlled double-blind trial.
TLDR
In studies with erythrocyte membranes, changes in electron spin resonance revealed that ursodeoxycholic acid was less toxic than chenode oxygencholic or deoxycholics acid, and coaddition of ursodesxycholic Acid prevented their toxic effect. Expand
Effect of ursodeoxycholic acid on serum lipids of patients with primary biliary cirrhosis.
TLDR
The cholesterol-lowering effect of UDCA could be related to amelioration of the underlying liver disease or to a direct effect of the drug on the metabolism of cholesterol in patients with hypercholesterolemia. Expand
A randomized, double-blind, placebo-controlled trial of ursodeoxycholic acid in primary biliary cirrhosis.
TLDR
Differences in ursodiol enrichment of the bile acid pool do not explain better responses of laboratory tests and histology found in patients with less advanced PBC. Expand
Cyclosporin A treatment in primary biliary cirrhosis: results of a long-term placebo controlled trial.
TLDR
CyA has some therapeutic potential in primary biliary cirrhosis, providing blood pressure and renal function are closely monitored, and Cox multivariate analysis showed time from entry to death or transplantation was significantly prolonged in the CyA-treated group. Expand
Characterisation of patients with a complete biochemical response to ursodeoxycholic acid.
TLDR
The association of greater UDCA enrichment with complete biochemical responses suggests that higher doses of UDCA should be evaluated, and patients with biochemically and histologically less severe disease, and greater enrichment of biliary bile with UDCA, are more likely to respond favourably to the drug. Expand
The canadian multicenter double‐blind randomized controlled trial of ursodeoxycholic acid in primary biliary cirrhosis
TLDR
Although treatment was not associated with any improvement in symptoms, ursodeoxycholic acid therapy caused the bilirubin to fall significantly within the first 3 mo of therapy (p<0.001), which led to an improvement in serum markers of cholestasis. Expand
Trial of penicillamine in advanced primary biliary cirrhosis.
TLDR
It is concluded that penicillamine is not useful for patients with histologically advanced primary biliary cirrhosis, and the trial is being continued in patients with early histologic disease whose better prognosis necessitates longer follow-up. Expand
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