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Ursodeoxycholic acid in the treatment of primary biliary cirrhosis.

Abstract：

BACKGROUND/AIMS:A double-blind, placebo-controlled trial of ursodeoxycholic acid (UDCA) was conducted in 180 patients with primary biliary cirrhosis (PBC) to define the efficacy and safety of UDCA. Efficacy was assessed by time to treatment failure defined as death; liver transplantation; histological progression; development of varices, ascites, or encephalopathy; doubling of total serum bilirubin levels; progression of fatigue or pruritus; drug toxicity; or voluntary withdrawal. METHODS:Patients with well-defined PBC underwent complete history, physical examination, liver chemistries, ultrasonography, upper endoscopy, and liver biopsy at entry as well as at 2 years. Liver chemistries were determined every 3 months. RESULTS:In patients receiving UDCA, treatment failure was delayed compared with the placebo-treated group (P = 0.0003, log rank test). Seven patients receiving UDCA died or required transplantation compared with 12 in the placebo group (P = 0.18). No patients discontinued UDCA because of side effects of toxicity. CONCLUSIONS:UDCA was extraordinarily safe and well tolerated, and its use was associated with delayed progression of the disease as defined in this study. However, the lack of effects on symptoms, histology, and the need for liver transplantation or survival indicate that further evaluation is necessary to determine the ultimate role of UDCA in the treatment of PBC.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Lindor KD,Dickson ER,Baldus WP,Jorgensen RA,Ludwig J,Murtaugh PA,Harrison JM,Wiesner RH,Anderson ML,Lange SM

doi

10.1016/0016-5085(94)90021-3

subject

Has Abstract,Author List Incomplete

pub_date

1994-05-01 00:00:00

pages

1284-90

issue

5

eissn

0016-5085

issn

1528-0012

pii

0016-5085(94)90021-3

journal_volume

106

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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