scholarly journals Oral vancomycin, ursodeoxycholic acid or no therapy for pediatric primary sclerosing cholangitis: a matched analysis

Hepatology ◽  
2020 ◽  
Author(s):  
Mark R. Deneau ◽  
Cara Mack ◽  
Douglas Mogul ◽  
Emily R. Perito ◽  
Pamela L. Valentino ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Oral Vancomycin

A Triple Blinded, Randomized, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of Oral Vancomycin in Primary Sclerosing Cholangitis: a Pilot Study

2016 ◽  
Vol 25 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Shahab Rahimpour ◽  
Mohsen Nasiri-Toosi ◽  
Hossein Khalili ◽  
Nasser Ebrahimi Daryani ◽  
Mohammad Kazem Nouri Taromlou ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Erythrocyte Sedimentation Rate ◽  
Primary Sclerosing Cholangitis ◽  
Sedimentation Rate ◽  
Sclerosing Cholangitis ◽  
Controlled Trial ◽  
Oral Vancomycin ◽  
Decrease Rate ◽  
Erythrocyte Sedimentation ◽  
Vancomycin Group

Background & Aim: Recent studies have suggested the therapeutic effect of antimicrobial agents on primary sclerosing cholangitis (PSC). Therefore, we aimed to evaluate the efficacy of oral vancomycin in patients with PSC. Method: A triple blinded, randomized, placebo-controlled trial was performed on 29 patients (2015-2016) in the Imam Khomeini Hospital, Tehran, Iran (NCT02605213). Patients were divided into two groups by simple randomization method: placebo 11 (37.9%)/vancomycin 18 (62.1%) and were treated with oral vancomycin (125 mg, four times a day) for 12 weeks. All patients in both groups simultaneously underwent treatment with ursodeoxycholic acid (UDCA, 300 mg, three times a day) before and during the study. Patients’ laboratory data and clinical symptoms were recorded at the beginning, first and third month after starting treatment, and the response to treatment was analyzed. Results: 29 patients with a mean age of 36.27±10.60 years were included in the study. Primary endpoints were accomplished in the vancomycin group showing a significant decline in the mean level of PSC Mayo risk score (decrease rate 3rd month – baseline = -322.03%, p=0.026) during follow up time. Moreover, the analysis of the level of alkaline phosphatase (ALP) in the vancomycin group showed a significant decrease in the third month of treatment as compared to its level in the first month (mean difference 3rd month -1st month = -142.92, Decrease rate= -18.24%, p=0.02). Among secondary endpoints, erythrocyte sedimentation rate (p=0.005), gamma-glutamyl transpeptidase (p=0.02) and patients’ symptoms including fatigue, pruritus, diarrhea and anorexia showed a significant decrease in the vancomycin group. Conclusion: This study demonstrated an acceptable efficacy of vancomycin in the treatment of PSC.  Abbreviations: BMI: body mass index ; ESR: Erythrocyte sedimentation rate; FIS-P: Fatigue Impact Scale- Persian; IBD: Inflammatory Bowel Disease; LSD: Least significant difference; PSC: Primary Sclerosing Cholangitis; RCT: Randomized, Controlled Trial; UDCA: Ursodeoxycholic acid; VAS: Visual Analogue Scale.

A case of symptomatic primary sclerosing cholangitis treated with ursodeoxycholic acid.

Kanzo ◽  
1992 ◽  
Vol 33 (7) ◽  
pp. 552-555
Author(s):  
Motoyoshi YANO ◽  
Hirotomo TAKESHIMA ◽  
Naoki HISHIDA ◽  
Hisao HAYASHI ◽  
Nobuo SAKAMOTO
Keyword(s):  
Ursodeoxycholic Acid ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis

scholarly journals Primary sclerosing cholangitis and pregnancy

2011 ◽  
Vol 1 (3) ◽  
pp. 55 ◽  
Author(s):  
Casper Q. Kammeijer ◽  
Robert A. De Man ◽  
Christianne J.M. De Groot
Keyword(s):  
Ursodeoxycholic Acid ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Rare Case ◽  
Progressive Disease ◽  
High Dose ◽  
Term Outcome ◽  
Long Term Outcome ◽  
In Pregnancy

Primary sclerosing cholangitis is a progressive disease, and coincidentally in pregnancy it is rare. It is characterized by progressive inflammation and destruction of bile ducts finally resulting in liver failure. A rare case of primary sclerosing cholangitis in pregnancy is presented. The course of the pregnancy was marked by threatened preterm delivery and exacerbation of cholestasis. She was successfully treated with ursodeoxycholic acid (UDCA). Although, primary sclerosing cholangitis has both maternal and fetal effects on pregnancy, the overall outcome is favorable. Only few cases have been reported using high dose ursodeoxycholic acid for primary sclerosing cholangitis in pregnancy, it often improves pruritus but has no protection against stillbirth. Data on the safety to the fetus or neonate and long-term outcome are scarce.

scholarly journals Successful Treatment of Recurrent Primary Sclerosing Cholangitis after Orthotopic Liver Transplantation with Oral Vancomycin

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Yinka K. Davies ◽  
Cynthia J. Tsay ◽  
Dario V. Caccamo ◽  
Kathleen M. Cox ◽  
Ricardo O. Castillo ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Liver Transplantation ◽  
Primary Sclerosing Cholangitis ◽  
Orthotopic Liver Transplantation ◽  
Successful Treatment ◽  
Sclerosing Cholangitis ◽  
Bile Ducts ◽  
Biliary Tree ◽  
Oral Vancomycin ◽  
Inflammatory Bowel

Primary sclerosing cholangitis (PSC) is a progressive, cholestatic disease of the liver that is marked by inflammation of the bile ducts and damage to the hepatic biliary tree. Approximately 60–70% of patients also have inflammatory bowel disease and progression of PSC can lead to ulcerative colitis and cirrhosis of the liver. Due to limited understanding of the etiology and mechanism of PSC, the only existing treatment option is orthotopic liver transplantation (OLT); however, recurrence of PSC, after OLT is estimated to be between 5% and 35%. We discuss the successful treatment of a pediatric patient, with recurrent PSC, after OLT with oral Vancomycin.

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