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Evidence summaries

Bile Acids for Primary Sclerosing Cholangitis

Ursodeoxycholic acid leads to a significant improvement in liver biochemistry, but there is insufficient evidence on its clinical effects in patients with primary sclerosing cholangitis. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 8 studies with a total of 592 subjects. Ursodeoxycholic acid (UDCA) did not significantly reduce the risk of death (RR 1.00; 95% CI 0.46 to 2.20); treatment failure including liver transplantation, varices, ascites, and encephalopathy (RR 1.22; 95% CI 0.91 to 1.64); liver histological deterioration (RR 0.89; 95% CI 0.45 to 1.74); or liver cholangiographic deterioration (RR 0.60; 95% CI 0.23 to 1.57). UDCA improved serum bilirubin (WMD -14.6 µmol/litre; 95% CI -18.7 to -10.6), alkaline phosphatases (WMD -506 IU/litre; 95% CI -583 to -430), aspartate aminotransferase (WMD -46 IU/litre; 95% CI -77 to -16), and gamma-glutamyltranspeptidase (WMD -260 IU/litre; 95% CI -315 to -205), but not albumin (WMD -0.20 g/litre; 95% CI -1.91 to 1.50). UDCA was well tolerated.

References

  • Poropat G, Giljaca V, Stimac D et al. Bile acids for primary sclerosing cholangitis. Cochrane Database Syst Rev 2011;(1):CD003626.[PubMed]. [PubMed]

Primary/Secondary Keywords