Low platelet count influences the performance of the different biochemical criteria of ursodeoxycholic acid therapy response in primary biliary cholangitis

2017 ◽  
Vol 66 (1) ◽  
pp. S355
Author(s):  
A. Reig ◽  
A. Pares
2021 ◽  
Vol 11 (2-S) ◽  
pp. 113-117
Author(s):  
Manali Sudhir Dhage ◽  
Nila Ganamurali ◽  
Dhivya Dhanasekaran ◽  
Sarvesh Sabarathinam

Background: Primary Biliary Cholangitis (PBC) is a persistent liver disease. Ursodeoxycholic acid is used as a first-line treatment for the past two decades. However, concurrent use of Ursodeoxycholic acid reported with a severe adverse drug reaction. Obeticholic acid has been started utilizing as monotherapy and also with Ursodeoxycholic acid in a patient who is intolerant to Ursodeoxycholic acid therapy. We primarily aimed to compare the pharmacokinetic & toxicity profiles of Ursodeoxycholic acid and Obeticholic acid using in silico methods. Method: The pharmacokinetic profile of UDCA & OCA was observed from PKCSM server online database, OSIRIS® property Explorer, T.E.S.T. (Toxicity estimation software tool) & Molinspiration® is used to estimate the drug toxicity profiles. Result: This computer-aided response provides a great understanding and creates a gap between the theoretical and clinical evidence for UDCA & OCA's preference in PBC management. Conclusion: Co-administration of Obeticholic acid with Ursodeoxycholic acid will be an effective treatment for PBC in patients with UDCA intolerants. However, both medications are well-recognized substrates of the CYP3A4 enzyme and may lead to unintended drug interactions and side effects. Keywords: Primary Biliary Cholangitis, Obeticholic acid, Ursodeoxycholic acid, CYP3A4, Drug Interactions, Pharmacokinetics.


2019 ◽  
Vol 71 (2) ◽  
pp. 357-365 ◽  
Author(s):  
Maren H. Harms ◽  
Henk R. van Buuren ◽  
Christophe Corpechot ◽  
Douglas Thorburn ◽  
Harry L.A. Janssen ◽  
...  

Gut ◽  
2019 ◽  
Vol 69 (8) ◽  
pp. 1502-1509 ◽  
Author(s):  
Maren H Harms ◽  
Rozanne C de Veer ◽  
Willem J Lammers ◽  
Christophe Corpechot ◽  
Douglas Thorburn ◽  
...  

ObjectiveThe clinical benefit of ursodeoxycholic acid (UDCA) in primary biliary cholangitis (PBC) has never been reported in absolute measures. The aim of this study was to assess the number needed to treat (NNT) with UDCA to prevent liver transplantation (LT) or death among patients with PBC.MethodsThe NNT was calculated based on the untreated LT-free survival and HR of UDCA with respect to LT or death as derived from inverse probability of treatment weighting-adjusted Cox proportional hazard analyses within the Global PBC Study Group database.ResultsWe included 3902 patients with a median follow-up of 7.8 (4.1–12.1) years. The overall HR of UDCA was 0.46 (95% CI 0.40 to 0.52) and the 5-year LT-free survival without UDCA was 81% (95% CI 79 to 82). The NNT to prevent one LT or death within 5 years (NNT5y) was 11 (95% CI 9 to 13). Although the HR of UDCA was similar for patients with and without cirrhosis (0.33 vs 0.31), the NNT5y was 4 (95% CI 3 to 5) and 20 (95% CI 14 to 34), respectively. Among patients with low alkaline phosphatase (ALP) (≤2× the upper limit of normal (ULN)), intermediate ALP (2–4× ULN) and high ALP (>4× ULN), the NNT5y to prevent one LT or death was 26 (95% CI 15 to 70), 11 (95% CI 8 to 17) and 5 (95% CI 4 to 8), respectively.ConclusionThe absolute clinical efficacy of UDCA with respect to LT or death varied with baseline prognostic characteristics, but was high throughout. These findings strongly emphasise the incentive to promptly initiate UDCA treatment in all patients with PBC and may improve patient compliance.


2017 ◽  
Vol 16 (3) ◽  
pp. 430-435 ◽  
Author(s):  
Yazmín Karel Melchor-Mendoza ◽  
Braulio Martínez-Benítez ◽  
Aline Mina-Hawat ◽  
Gustavo Rodríguez-Leal ◽  
Ximena Duque ◽  
...  

2020 ◽  
Vol 50 (2) ◽  
pp. 214-223
Author(s):  
Nozomi Amano ◽  
Yuji Ikeda ◽  
Sho Hayashida ◽  
Sho Takahashi ◽  
Sho Sato ◽  
...  

Doctor Ru ◽  
2019 ◽  
Vol 158 (3) ◽  
pp. 33-39
Author(s):  
E.V. Vinnitskaya ◽  
◽  
K.G. Absandze ◽  
E.V. Arkhipova ◽  
A.N. Ivanov ◽  
...  

Author(s):  
Tanwi Singh ◽  
Anshuman Sinha

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery. Hence based on above findings the present study was planned for Assessment of the Platelet Count in the Pregnant Women in IGIMS, Patna, Bihar. The present study was planned in Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India. The present study was planned from duration of January 2019 to June 2019. In the present study 200 pregnant females samples received for the platelet estimation were enrolled in the present study. Clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease. Platelet count is a simple, low cost, and rapid routine screening test. Hence the data generated from the present study concludes that platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period. Keywords: Platelet Count, Pregnant Women, IGIMS, Patna, Bihar, etc.


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