Mid-dosage ursodeoxycholic acid treatment for primary biliary cirrhosis:a systematic review
- VernacularTitle:中等剂量熊去氧胆酸治疗原发性胆汁性肝硬化的系统评价
- Author:
Jian SHI
;
Su LIU
;
Weizhong CHEN
- Publication Type:Journal Article
- Keywords:
Ursodeoxycholic acid;
Liver cirrhosis,biliary;
Systematic review
- From:
Chinese Journal of Digestion
1998;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the long-term efficacy and safety of mid-dosage (13～15 mg?kg-1?g-1) ursodeoxycholic acid (UDCA) treatment for primary biliary cirrhosis (PBC). Methods A systematic review of all randomized controlled trials (RCT) comparing UDCA with placebo was performed. Results Seven trials including 1038 patients were assessed. UDCA could significantly improve liver biochemistry, but had no effect on pruritus and fatigue. In the patients with initial stage Ⅰ-Ⅱ, there was a significant decrease in the histologic progression after treatment with UDCA for 2 years compared with the placcebo group(P=0.03), but there was no significant difference between the two groups when considering overall patients with initial stage Ⅰ-Ⅳ (P=0.08). Meta-analysis showed no significant difference in the incidence of death (odds ratio 0.99, 95% confidence interval 0.62-1.58), liver related death (1.05, 0.53-2.05), liver trans-plantation (0.87, 0.53-1.41), death and/or liver transplantation (0.92, 0.64-1.31) and liver decompensation (0.94, 0.60-1.49) between the UDCA and placebo groups. Conclusions The analysis of RCTs of UDCA versus placebo shows improvement of liver biochemistry, but not improvement of clinical symptoms and survival. UDCA may slow down liver histologic progression in the early-stage patients with PBC.
