Autoimmune conditions associated with primary biliary cirrhosis: response to ursodeoxycholic acid therapy.
OBJECTIVE
A variety of autoimmune conditions occur in association with primary biliary cirrhosis. Among these conditions are sicca syndrome, Raynaud's phenomenon, arthritis, and Hashimoto's thyroiditis. Information is sparse regarding the prevalence and natural history of these conditions when associated with primary biliary cirrhosis and their response to ursodeoxycholic acid treatment. We evaluated the prevalence, natural history, and response to ursodeoxycholic acid therapy of these conditions coassociated with primary biliary cirrhosis.


METHODS
One hundred-eighty patients with primary biliary cirrhosis, enrolled in a prospective randomized controlled trial of ursodeoxycholic acid (13-15 mg/ kg/day), were included. Patients were assessed at study entry and annually.


RESULTS
At entry, 77/180 patients (43%) had one of the four conditions, and 18/180 patients (10%) had two or more conditions. Sicca syndrome was the most common, occurring in 58/180 patients (32%). After 2 yr, there was no difference between the treatment groups with regard to resolution or spontaneous onset of these autoimmune features. Sicca syndrome was the most common spontaneously developing condition (9% per yr). Sicca syndrome was the most common associated autoimmune condition, present in one-third of our patients. The associated conditions tended to improve over time, with a low rate of spontaneously developing these conditions. Although ursodeoxycholic acid therapy leads to improvement in the underlying liver disease, it did not appear to influence either the development or resolution of these autoimmune features.


CONCLUSIONS
Although ursodeoxycholic acid is beneficial in the treatment of primary biliary cirrhosis, it had no measurable effect on the autoimmune conditions coassociated with the disease.
Zukowski
T H
TH
Mayo Foundation, Rochester, Minnesota, USA.
Jorgensen
R A
RA
Dickson
E R
ER
Lindor
K D
KD
D001168:Arthritis / Q000150:complications / Q000188:drug therapy; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy*; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011928:Raynaud Disease / Q000150:complications / Q000188:drug therapy; D012859:Sjogren's Syndrome / Q000150:complications / Q000188:drug therapy; D013967:Thyroiditis, Autoimmune / Q000150:complications / Q000188:drug therapy; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid