Dose effect of ursodeoxycholic acid used in the treatment of primary biliary cirrhosis and primary sclerosing cholangitis

2007 ◽  
pp. 225-229 ◽  
Author(s):  
K. D. Lindor
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Ursodeoxycholic Acid ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Dose Effect ◽  
Biliary Cirrhosis

scholarly journals Urisodeoxycholic Acid in Treatment of Liver Cirrhosis

2021 ◽  
Vol 9 (9) ◽  
pp. 1869-1873
Author(s):  
Sangale Mukta
Keyword(s):  
Liver Cirrhosis ◽  
Bile Acid ◽  
Primary Biliary Cirrhosis ◽  
Ursodeoxycholic Acid ◽  
Primary Sclerosing Cholangitis ◽  
Liver Diseases ◽  
Sclerosing Cholangitis ◽  
Chronic Liver ◽  
Biliary Cirrhosis ◽  
Chronic Liver Diseases

Abstract: Ursodeoxycholic acid is a dihy- droxy bile acid with a rapidly expanding spectrum of usage in acute and chronic liver diseases. The various mechanisms of action of this hydrophilic bile acid include direct cytoprotection, detergent action on dysfunctional microtubules, immunomodulation and induction of hypercholer- esis. Its efficacy in primary biliary cirrhosis and primary sclerosing cholangitis as an adjunct to medical therapy has been well established.Ursodeoxycholic acid prolongs survival in primary biliary cirrhosis and it improves biochemical parameters of cholestasis in various other cholestatic disorders including primary sclerosing cholangitis, intrahepatic cholestasis of pregnancy, cystic fibrosis and total parenteral nutritioninduced cholestasis. However, a positive effect on survival remains to be established in these diseases. Ursodeoxycholic acid is of unproven efficacy in non- cholestatic disorders such as acute rejection after liver transplantation, non-alcoholic steatohepatitis, alcoholic liver disease and chronic viral hepatitis. This review outlines the present knowledge of the Pharmacology of ursodeoxycholic acid, and presents data from clinical trials on its use in chronic liver diseases. Keywords: Liver cirrhosis, Urisodeoxycholic acid

scholarly journals Diagnosis and Management of the Overlap Syndromes of Autoimmune Hepatitis

2013 ◽  
Vol 27 (7) ◽  
pp. 417-423 ◽  
Author(s):  
Albert J Czaja
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Autoimmune Hepatitis ◽  
Ursodeoxycholic Acid ◽  
Immunosuppressive Therapy ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Overlap Syndrome ◽  
Biliary Cirrhosis ◽  
Diagnostic Features ◽  
Overlap Syndromes

BACKGROUND: Autoimmune hepatitis may have cholestatic features that are outside the classical phenotype and that resemble findings in other immune-mediated liver diseases. These cholestatic phenotypes have been designated ‘overlap syndromes’.OBJECTIVES: To recognize the overlap syndromes in adults and manage them appropriately.METHODS: The MEDLINE database was reviewed for published experiences from 1984 to 2013.RESULTS: Patients with autoimmune hepatitis may exhibit features of primary biliary cirrhosis (7% to 13%), primary sclerosing cholangitis (6% to 11%) or a cholestatic syndrome without other diagnostic features (5% to 11%). These mixed phenotypes may represent classical autoimmune hepatitis with atypical features, transition states in the evolution of classical cholestatic syndromes, concurrent separate diseases or pathogenically distinct disorders. The ‘Paris criteria’ have been endorsed for the diagnosis of the overlap syndrome with primary biliary cirrhosis, and treatment with conventional immunosuppressive therapy alone or in combination with low-dose ursodeoxycholic acid can be guided by the serum alkaline phosphatase level. The overlap syndrome with primary sclerosing cholangitis or with cholestasis without diagnostic features is commonly treated with immunosuppressive therapy and ursodeoxycholic acid. Responses are variable and commonly incomplete (20% to 100% improvement) depending on the degree of cholestasis.DISCUSSION: The overlap syndromes are clinical descriptions rather than pathological entities, and the dominant component of the disease determines its designation and therapy. Cholestatic findings in autoimmune hepatitis influence the response to immunosuppressive therapy.CONCLUSION: The overlap syndromes must be considered in patients with autoimmune hepatitis and cholestatic findings, concurrent inflammatory bowel disease or steroid-refractory disease.

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