URSODEOXYCHOLIC ACID FOR PRIMARY SCLEROSING CHOLANGITIS

The effects of ursodeoxycholic acid (UDCA, 750-1250 mg/day) were evaluated prospectively in 15 patients with primary sclerosing cholangitis (PSC). Five patients had associated inflammatory bowel disease. After 6 months of treatment, the proportion of patients suffering from fatigue or pruritus decreased from 60% to 20% and from 33% to 20%, respectively. No exacerbation of associated disorders was observed. Serum alkaline phosphatase levels (normal < 100 IU/l) decreased from 401 ± 53 to 222 ± 42 (mean ± S.E.; p < 0.001), those of γ-glutamyl transpeptidase, (normal < 40 IU/l) from 520 ± 89 to 185 ± 32 (p < 0.001) and those of alanine aminotransferases, (normal < 30 IU/l) from 79 ± 12 to 42 ± 6 (p < 0.02). In three patients, the discontinuation of UDCA was associated with an aggravation of the liver test results. In conclusion, this study shows that 6 months of treatment with UDCA leads to clinical and biochemical improvements in patients with PSC. These results suggest that UDCA could be an effective treatment for PSC, and may justify a controlled therapeutic trial. © 1990.