Trials of ursodeoxycholic acid for the treatment of primary biliary cholangitis (primary biliary cirrhosis)
- Steven Flamm, MD
Steven Flamm, MD
- Chief, Liver Transplantation Program
- Professor of Medicine
- Feinberg School of Medicine
- Northwestern University
- Raoul Poupon, MD
Raoul Poupon, MD
- Professor of Hepatology and Gastroenterology
- University Pierre et Marie Curie
- UPMC, Sorbonne University, Paris, France
Ursodeoxycholic acid (UDCA) was proposed as a potential therapy for cholestatic liver disease based on the following rationales: accumulation of toxic bile acids might be at least partially responsible for liver injury in chronic cholestasis, and replacement of endogenous bile acids by a non-toxic bile acid (UDCA) might protect the liver and retard the progression of these disorders. In preliminary studies of patients with primary biliary cholangitis (PBC; previously referred to as primary biliary cirrhosis) , UDCA was found to provide marked improvement in liver tests, leading to randomized trials and meta-analyses that also found a benefit. UDCA is generally well tolerated. Side effects may include headache, weight gain , constipation, and diarrhea.
Experimental and clinical evidence suggest that at least four mechanisms of action are involved in the beneficial therapeutic effects of UDCA in cholestatic disorders :
●An increased hydrophilicity index of the circulating bile acid pool
●Stimulation of hepatocellular and ductular secretions
●Cytoprotection against bile acid- and cytokine-induced injuryTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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