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. 1998 Aug;74(874):482–485. doi: 10.1136/pgmj.74.874.482

Ursodeoxycholic acid therapy for primary biliary cirrhosis. A 10-year British single-centre population-based audit of efficacy and survival.

M C Bateson 1, P Gedling 1
PMCID: PMC2360897  PMID: 9926123

Abstract

The effect of ursodeoxycholic acid treatment on survival in primary biliary cirrhosis was studied in 40 patients with symptomatic disease. Two patients developed early exacerbation of symptoms and stopped therapy in days; they are both alive 4 and 4 1/2 years later. The other 38 patients have continued on treatment for up to 10 years. Results were compared with 12 other similar cases previously seen but not given specific therapy. Kaplan-Meier analysis showed that ursodeoxycholic acid treatment was associated with better survival (p < 0.05) after the first two years of therapy. Predictors of favourable outcome included histological stage I disease. In 26 patients with primary biliary cirrhosis stage II, III or IV, therapy showed a trend to improved survival, but this was still significantly worse than the general population. Prognosis was not different between these different advanced stages. Symptoms improved in 28 out of 40 patients on ursodeoxycholic acid, but 50% had a recurrence by two years.

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Selected References

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  1. Balasubramaniam K., Grambsch P. M., Wiesner R. H., Lindor K. D., Dickson E. R. Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study. Gastroenterology. 1990 Jun;98(6):1567–1571. doi: 10.1016/0016-5085(90)91091-j. [DOI] [PubMed] [Google Scholar]
  2. Bateson M. C., Ross P. E., Murison J., Saunders J. H., Bouchier I. A. Ursodeoxycholic acid therapy and biliary lipids--a dose-response study. Gut. 1980 Apr;21(4):305–310. doi: 10.1136/gut.21.4.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Batta A. K., Salen G., Arora R., Shefer S., Tint G. S., Abroon J., Eskreis D., Katz S. Effect of ursodeoxycholic acid on bile acid metabolism in primary biliary cirrhosis. Hepatology. 1989 Oct;10(4):414–419. doi: 10.1002/hep.1840100404. [DOI] [PubMed] [Google Scholar]
  4. Crosignani A., Podda M., Battezzati P. M., Bertolini E., Zuin M., Watson D., Setchell K. D. Changes in bile acid composition in patients with primary biliary cirrhosis induced by ursodeoxycholic acid administration. Hepatology. 1991 Dec;14(6):1000–1007. [PubMed] [Google Scholar]
  5. Eriksson L. S., Olsson R., Glauman H., Prytz H., Befrits R., Rydén B. O., Einarsson K., Lindgren S., Wallerstedt S., Wedén M. Ursodeoxycholic acid treatment in patients with primary biliary cirrhosis. A Swedish multicentre, double-blind, randomized controlled study. Scand J Gastroenterol. 1997 Feb;32(2):179–186. doi: 10.3109/00365529709000190. [DOI] [PubMed] [Google Scholar]
  6. Heathcote E. J., Cauch-Dudek K., Walker V., Bailey R. J., Blendis L. M., Ghent C. N., Michieletti P., Minuk G. Y., Pappas S. C., Scully L. J. The Canadian Multicenter Double-blind Randomized Controlled Trial of ursodeoxycholic acid in primary biliary cirrhosis. Hepatology. 1994 May;19(5):1149–1156. [PubMed] [Google Scholar]
  7. Heuman D. M. Hepatoprotective properties of ursodeoxycholic acid. Gastroenterology. 1993 Jun;104(6):1865–1870. doi: 10.1016/0016-5085(93)90672-y. [DOI] [PubMed] [Google Scholar]
  8. Kaplan M. M. Primary biliary cirrhosis. N Engl J Med. 1996 Nov 21;335(21):1570–1580. doi: 10.1056/NEJM199611213352107. [DOI] [PubMed] [Google Scholar]
  9. Lim A. G., Jazrawi R. P., Northfield T. C. The ursodeoxycholic acid story in primary biliary cirrhosis. Gut. 1995 Sep;37(3):301–304. doi: 10.1136/gut.37.3.301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lindor K. D., Therneau T. M., Jorgensen R. A., Malinchoc M., Dickson E. R. Effects of ursodeoxycholic acid on survival in patients with primary biliary cirrhosis. Gastroenterology. 1996 May;110(5):1515–1518. doi: 10.1053/gast.1996.v110.pm8613058. [DOI] [PubMed] [Google Scholar]
  11. Locke G. R., 3rd, Therneau T. M., Ludwig J., Dickson E. R., Lindor K. D. Time course of histological progression in primary biliary cirrhosis. Hepatology. 1996 Jan;23(1):52–56. doi: 10.1002/hep.510230108. [DOI] [PubMed] [Google Scholar]
  12. Mahl T. C., Shockcor W., Boyer J. L. Primary biliary cirrhosis: survival of a large cohort of symptomatic and asymptomatic patients followed for 24 years. J Hepatol. 1994 Jun;20(6):707–713. doi: 10.1016/s0168-8278(05)80139-4. [DOI] [PubMed] [Google Scholar]
  13. Metcalf J. V., Mitchison H. C., Palmer J. M., Jones D. E., Bassendine M. F., James O. F. Natural history of early primary biliary cirrhosis. Lancet. 1996 Nov 23;348(9039):1399–1402. doi: 10.1016/S0140-6736(96)04410-8. [DOI] [PubMed] [Google Scholar]
  14. Mitchison H. C., Lucey M. R., Kelly P. J., Neuberger J. M., Williams R., James O. F. Symptom development and prognosis in primary biliary cirrhosis: a study in two centers. Gastroenterology. 1990 Sep;99(3):778–784. doi: 10.1016/0016-5085(90)90968-7. [DOI] [PubMed] [Google Scholar]
  15. Poupon R. E., Chrétien Y., Poupon R., Paumgartner G. Serum bile acids in primary biliary cirrhosis: effect of ursodeoxycholic acid therapy. Hepatology. 1993 Apr;17(4):599–604. doi: 10.1002/hep.1840170412. [DOI] [PubMed] [Google Scholar]
  16. Poupon R. E., Lindor K. D., Cauch-Dudek K., Dickson E. R., Poupon R., Heathcote E. J. Combined analysis of randomized controlled trials of ursodeoxycholic acid in primary biliary cirrhosis. Gastroenterology. 1997 Sep;113(3):884–890. doi: 10.1016/s0016-5085(97)70183-5. [DOI] [PubMed] [Google Scholar]
  17. Poupon R. E., Poupon R., Balkau B. Ursodiol for the long-term treatment of primary biliary cirrhosis. The UDCA-PBC Study Group. N Engl J Med. 1994 May 12;330(19):1342–1347. doi: 10.1056/NEJM199405123301903. [DOI] [PubMed] [Google Scholar]
  18. Poupon R., Chrétien Y., Poupon R. E., Ballet F., Calmus Y., Darnis F. Is ursodeoxycholic acid an effective treatment for primary biliary cirrhosis? Lancet. 1987 Apr 11;1(8537):834–836. doi: 10.1016/s0140-6736(87)91610-2. [DOI] [PubMed] [Google Scholar]
  19. Setchell K. D., Rodrigues C. M., Podda M., Crosignani A. Metabolism of orally administered tauroursodeoxycholic acid in patients with primary biliary cirrhosis. Gut. 1996 Mar;38(3):439–446. doi: 10.1136/gut.38.3.439. [DOI] [PMC free article] [PubMed] [Google Scholar]

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