title: Ursodeoxycholic acid in patients with ulcerative colitis and primary sclerosing cholangitis for prevention of colon cancer: a meta-analysis.
abstract: OBJECTIVE
  Colon cancer risk is high in patients with ulcerative colitis (UC) and primary sclerosing cholangitis (PSC). Ursodeoxycholic acid has been shown to have some promise as a chemopreventive agent. A meta-analysis was performed to compare the efficacy of ursodeoxycholic acid in the prevention of colonic neoplasia in patients with UC and PSC.
  
  
  METHODS
  Multiple databases were searched (January 2011). Studies examining the use of ursodeoxycholic acid vs. no ursodeoxycholic acid or placebo in adult patients with UC and PSC were included. Data were extracted in standard forms by two independent reviewers. Meta-analysis for the effect of ursodeoxycholic acid was performed by calculating pooled estimates of adenoma or colon cancer formation by odds ratio (OR) with random effects model. Heterogeneity was assessed by calculating the I (2) measure of inconsistency. RevMan 5 was utilized for statistical analysis.
  
  
  RESULTS
  Four studies (n = 281) met the inclusion criteria. The studies were of adequate quality. Ursodeoxycholic acid demonstrated no overall improvement in adenoma (OR 0.53; 95 % CI: 0.19-1.48, p = 0.23) or colon cancer occurrence (OR 0.50; 95 % CI: 0.18-1.43, p = 0.20) as compared to no ursodeoxycholic acid or placebo in patients with UC and PSC.
  
  
  CONCLUSIONS
  Ursodeoxycholic acid use in patients with UC and PSC does not appear to decrease the risk of adenomas or colon cancer.
authors.affiliation: Division of Gastroenterology and Hepatology, CE405, DC 043.00, University of Missouri Health Sciences Center, Five Hospital Drive, Columbia, MO 65212, USA.
authors.forename: Imran
authors.initials: I
authors.lastname: Ashraf
authors.forename: Abhishek
authors.initials: A
authors.lastname: Choudhary
authors.forename: Murtaza
authors.initials: M
authors.lastname: Arif
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Matteson
authors.forename: Hazem T
authors.initials: HT
authors.lastname: Hammad
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Puli
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bechtold
mesh_terms: D000236:Adenoma / Q000517:prevention & control*; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000188:drug therapy*; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy*; D003110:Colonic Neoplasms / Q000517:prevention & control*; D006801:Humans; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid