High-dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis

被引:20
作者
Smith T. [1 ]
Befeler A.S. [1 ]
机构
[1] Divsion of Gastroenterology and Hepatology, Saint Louis University, St Louis, MO 63110
基金
美国国家卫生研究院;
关键词
Bile Acid; Primary Biliary Cirrhosis; Primary Sclerosing Cholangitis; Cholic Acid; Ursodeoxycholic Acid;
D O I
10.1007/s11894-008-0021-z
中图分类号
学科分类号
摘要
Primary sclerosing cholangitis (PSC) is a cholestatic liver disease that results in progressive fibrosis of intrahepatic and extrahepatic bile ducts. No effective therapy currently exists for this disease. Ursocleoxycholic acid (UDCA), a hydrophilic bile acid, is the most promising treatment option because of its benign side effect profile and documented benefit in the treatment of other cholestatic liver diseases, including primary biliary cirrhosis. Multiple studies using standard-dosage (8-15 mg/kg/d) and high-dosage (20-30 mg/kg/d) UDCA generally show improvement in liver chemistries in PSC patients, and several show improvement in liver histology. However, the majority of trials using UDCA in PSC are underpowered and fail to show improvements in clinically relevant endpoints, such as delayed progression to cirrhosis, portal hypertension, liver transplantation, development of cholangiocarcinoma, or death. Copyright © 2007 by Current Medicine Group LLC.
引用
收藏
页码:54 / 59
页数:5
相关论文
共 48 条
[1]
Wiesner R.H., Grambsch P.M., Dickson E.R., Et al., Primary sclerosing cholangitis: Natural history, prognostic factors and survival analysis, Hepatology, 10, pp. 430-436, (1989)
[2]
Burak K., Angulo P., Pasha T.M., Et al., Incidence and risk factors for cholangiocarcinoma in primary sclerosing cholangitis, Am J Gastroenterol, 99, pp. 523-526, (2004)
[3]
Lee Y., Kaplan M.M., Primary sclerosing cholangitis, N Engl J Med, 332, pp. 924-933, (1995)
[4]
Lindor K.D., Dickson E.R., Baldus W.P., Et al., Ursodeoxycholic acid in the treatment of primary biliary cirrhosis, Gastroenterology, 106, pp. 1284-1290, (1994)
[5]
Lindor K.D., Therneau T.M., Jorgensen R.A., Et al., Effects of ursodeoxycholic acid on survival in patients with primary bitiary cirrhosis, Gastroenterology, 110, pp. 1515-1518, (1996)
[6]
Poupon R.E., Lindor K.D., Cauch-Dudek K., Et al., Combined analysis of randomized controlled trials of ursodeoxycholic acid in primary bitiary cirrhosis, Gastroenterology, 113, pp. 884-890, (1997)
[7]
Angulo P., Batts K.P., Therneau T.M., Et al., Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis, Hepatology, 29, pp. 644-647, (1999)
[8]
Angulo P., Dickson E.R., Jorgensen R.A., Et al., Comparison of three doses of ursodeoxycholic acid in the treatment of primary biliary cirrhosis: A randomized trial, J Hepatol, 30, pp. 830-835, (1999)
[9]
Colombo C., Battezzati, Podda M., Et al., Ursodeoxycholic acid for liver disease associated with cystic fibrosis: A double-blind multicenter trial, Hepatology, 23, pp. 1484-1490, (1996)
[10]
Benedetti A., Alvaro D., Bassotti C., Et al., Cytotoxicity of bile salts against biliary epithelium: A study in isolated bile ductile fragments and isolated perfused rat liver, Hepatology, 26, pp. 9-21, (1997)