Clinical

Ursodeoxycholic acid helpful in biliary cirrhosis

Last Updated: 2006-08-14 14:40:20 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A meta-analysis of studies involving more than a thousand subjects indicates that long-term treatment with ursodeoxycholic acid is beneficial in patients with primary biliary cirrhosis and may reduce the need for liver transplantation, according to Chinese researchers.

In the July issue of the American Journal of Gastroenterology, Dr. Wei-fen Xie and colleagues at Second Military Medical University, Shanghai note that the treatment is known to improve liver function but its effect on survival and other factors are unclear.

To investigate further, the researchers studied data from 7 randomized controlled trials. Six of these were placebo-controlled and in the seventh the control group was untreated.

Although the active treatment had no effect on pruritus and fatigue, there was a significant improvement in liver biochemistry and a delay in disease progression, particularly in early-stage patients.

In addition, meta-analysis of the studies and their extended follow-up showed a significant reduction in liver transplantation (odds ratio, 0.65). For the combined end point of death or liver transplantation, there was a marginally significant reduction.

Further analysis in trials selected for being large-scale, lasting 48 months or more or being placebo-controlled, showed that long-term treatment did significantly reduce the incidence of liver transplantation or death and liver transplantation.

Given these findings, the researchers conclude that "we should start ursodeoxycholic acid treatment in... patients with primary biliary cirrhosis as early as possible."

Am J Gastroenterol 2006; 101:1529-1538.