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 less than 100 IU/l) decreased from 401 +/- 53 to 222 +/- 42 (mean +/- S.E.; p less than 0.001), those of gamma-glutamyl transpeptidase, (normal less than 40 IU/l) from 520 +/- 89 to 185 +/- 32 (p less than 0.001) and those of alanine aminotransferases, (normal less than 30 IU/l) from 79 +/- 12 to 42 +/- 6 (p less than 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.
Chazouillères
O
O
Hôpital Saint-Antoine, Paris, France.
Poupon
R
R
Capron
J P
JP
Metman
E H
EH
Dhumeaux
D
D
Amouretti
M
M
Couzigou
P
P
Labayle
D
D
Trinchet
J C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D015209:Cholangitis, Sclerosing / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D003840:Deoxycholic Acid / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000201:enzymology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D000637:Transaminases / Q000097:blood; D014580:Ursodeoxycholic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D005723:gamma-Glutamyltransferase / Q000097:blood
D003840:Deoxycholic Acid; D014580:Ursodeoxycholic Acid; D005723:gamma-Glutamyltransferase; D000637:Transaminases; D000469:Alkaline Phosphatase