title: Ursodeoxycholic acid treatment in primary biliary cirrhosis with the emphasis on late stage disease.
abstract: We studied the effect of ursodeoxycholic acid in 19 patients with primary biliary cirrhosis, mainly stages III and IV. The dose of UDCA employed was 10-15 mg/kg body weight per day. After 1 yr, 17 patients were still using UDCA, and the mean values of serum alkaline phosphatase, gamma-glutamyltranspeptidase and alanine-aminotransferase had fallen significantly. Serum bilirubin, initially elevated in 7 of the 13 late-stage (III and IV) patients, showed a further increase in 3 of the 7 patients. In 2 of these 3 patients, UDCA had to be withdrawn (dose reduction had no effect). One patient developed a decompensated cirrhosis in spite of UDCA withdrawal. Pruritus worsened in 4 patients, all of whom were late stage patients. Ten late-stage (III-IV) patients showed improvement in liver biochemistry and clinical findings as did all early-stage PBC patients. Thus, UDCA treatment is not beneficial for all PBC patients. Special care should be taken in the early phase of UDCA therapy in later-stage (III-IV) patients: frequent biochemical checks should be carried out, for instance every 2 weeks in the first 2 months after starting UDCA, especially the estimation of bilirubin.
authors.affiliation: Department of Hepato-gastroenterology, Free University Hospital Amsterdam, Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: Kneppelhout
authors.forename: C J
authors.initials: CJ
authors.lastname: Mulder
authors.forename: G P
authors.initials: GP
authors.lastname: van Berge Henegouwen
authors.forename: R A
authors.initials: RA
authors.lastname: de Vries
authors.forename: K H
authors.initials: KH
authors.lastname: Brandt
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000188:drug therapy*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D011446:Prospective Studies; D011537:Pruritus / Q000139:chemically induced; D013997:Time Factors; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D014580:Ursodeoxycholic Acid