title: Ursodeoxycholic acid in primary sclerosing cholangitis: meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The effect of ursodeoxycholic acid (UDCA) treatment on survival and liver histological progression of primary sclerosing cholangitis (PSC) remains uncertain. The aim of the present study was to evaluate the effect and safety of UDCA in PSC.
  
  
  METHODS
  Electronic databases including Medline, Embase, Cochrane controlled trials register, Web of Science and PubMed (updated to January 2009) and manual bibliographical searches were carried out. A meta-analysis of all randomized controlled trials (RCT) comparing UDCA with placebo or no treatment was carried out.
  
  
  RESULTS
  Eight RCT including 465 patients were assessed. UDCA could significantly improve liver biochemistry, but had no effect on pruritus and fatigue. Meta-analysis of the included RCT showed UDCA had no significant effect on the incidence of death, liver transplantation, and death and/or liver transplantation. However, a significant difference for the incidence of histological improvement was found between the two groups (odds ratio [OR], 9.19; 95% CI: 0.98, 86.15; P = 0.05). Meta-analysis also indicated a reduction trend of histological deterioration and an improvement trend of cholangiographic changes. These trends were constant in the sensitivity analyses.
  
  
  CONCLUSIONS
  The meta-analysis found that UDCA can improve liver biochemistry and there is a trend towards improvement in liver histology and cholangiography, but has no effect on survival free of transplantation.
authors.affiliation: Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Shi
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
authors.forename: Xin
authors.initials: X
authors.lastname: Zeng
authors.forename: Yong
authors.initials: Y
authors.lastname: Lin
authors.forename: Wei-Fen
authors.initials: WF
authors.lastname: Xie