Ursodeoxycholic acid for primary biliary cirrhosis.

Abstract:

BACKGROUND:Primary biliary cirrhosis is a rare autoimmune liver disease and an effective treatment has been difficult to establish. Some randomised clinical trials have found an effect of ursodeoxycholic acid for primary biliary cirrhosis. OBJECTIVES:Evaluate the beneficial effects and adverse effects of peroral ursodeoxycholic acid for primary biliary cirrhosis versus placebo or no intervention. SEARCH STRATEGY:The Controlled Trials Register of The Cochrane Hepato-Biliary Group, The Cochrane Library, MEDLINE, EMBASE and the full text of the identified studies were searched until April 2001. The electronic searches were done by entering the search terms 'ursodeoxycholic acid', 'UDCA', 'primary biliary cirrhosis', and 'PBC'. SELECTION CRITERIA:Randomised clinical trials evaluating ursodeoxycholic acid administered perorally at any dose versus placebo or no intervention in patients with primary biliary cirrhosis diagnosed by any method. Only trials using an adequate method for randomisation were included, regardless of blinding and language. DATA COLLECTION AND ANALYSIS:The methodologic quality of the randomised clinical trials was evaluated by components and the Jadad-score. The following outcomes were extracted: mortality, liver transplantation, pruritus, other clinical symptoms (jaundice, portal pressure, (bleeding) oesophageal varices, ascites, hepatic encephalopathy, hepato-renal syndrome, autoimmune conditions), liver biochemistry, liver function, liver biopsy findings, quality of life, and adverse events. All analyses were performed according to the intention-to-treat method. MAIN RESULTS:A total of 16 randomised clinical trials evaluating ursodeoxycholic acid against placebo (n = 15) or no intervention (n = 1) in 1422 patients were identified. The median Jadad-score was 3 (range 1-5). A number of trials described as double blind had problems with the blinding. Neither mortality (odds ratio = 0.94; 95% confidence interval (CI) 0.60 to 1.48), liver transplantation (odds ratio = 0.83; 95% CI 0.52 to 1.32), mortality or liver transplantation (odds ratio = 0.90; 95% CI 0.65 to 1.26), pruritus, fatigue, autoimmune conditions, quality of life, liver histology, or portal pressure were significantly affected by ursodeoxycholic acid (given in doses of 8-15 mg/kg/day for three months to five years). However, ursodeoxycholic acid significantly (P < 0.05) reduced ascites, jaundice, and biochemical variables such as serum bilirubin and liver enzymes. Ursodeoxycholic acid was not significantly associated with adverse events. Including data after patients had been switched onto open label ursodeoxycholic acid confirmed the findings regarding the lack of a significant effect of ursodeoxycholic acid on mortality and mortality or liver transplantation. A significant (P = 0.04) effect was, however, observed on the incidence of liver transplantation (odds ratio = 0.68; 95% CI 0.48 to 0.98). REVIEWER'S CONCLUSIONS:Ursodeoxycholic acid has a marginal therapeutic effect for primary biliary cirrhosis. On the positive side, ursodeoxycholic acid has few side effects. The general usage of ursodeoxycholic acid for primary biliary cirrhosis needs reevaluation.

authors

Gluud C,Christensen E

doi

10.1002/14651858.CD000551

keywords:

subject

Has Abstract

pub_date

2002-01-01 00:00:00

pages

CD000551

issue

1

issn

1469-493X

pii

CD000551

pub_type

杂志文章,评审
  • Antibiotics for acute bronchitis.

    abstract:BACKGROUND:The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care. OBJECTIVES:To assess the effects of antibiotics in improving outcomes and assess adverse effects of antibiotic therapy for patients with a clinical diagnosis of a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000245.pub3

    authors: Smith SM,Fahey T,Smucny J,Becker LA

    更新日期:2014-03-01 00:00:00

  • Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus.

    abstract:BACKGROUND:Patients with type 2 diabetes mellitus (T2D) have an increased risk of cardiovascular disease and mortality compared to the background population. Observational studies report an association between reduced blood glucose and reduced risk of both micro- and macrovascular complications in patients with T2D. Ou...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008143.pub3

    authors: Hemmingsen B,Lund SS,Gluud C,Vaag A,Almdal TP,Hemmingsen C,Wetterslev J

    更新日期:2013-11-11 00:00:00

  • Water for preventing urinary stones.

    abstract:BACKGROUND:Urinary stones are a common condition characterised by high incidence and high recurrence rate. For a long time, increased water intake has been the main preventive measure for the disease and its recurrence. This is an update of a review originally published in 2004. OBJECTIVES:To assess the effectiveness ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004292.pub3

    authors: Bao Y,Wei Q

    更新日期:2012-06-13 00:00:00

  • Chinese herbal medicines for induction of remission in advanced or late gastric cancer.

    abstract:BACKGROUND:Gastric cancer is difficult to cure once it progresses into an advanced or late stage. Although some chemotherapies or bio-therapies have made progress in the remission of this disease, mortality remains high. A variety of Chinese medicinal herbs have been used to treat gastric cancer. OBJECTIVES:To assess ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005096.pub2

    authors: Gan T,Wu Z,Tian L,Wang Y

    更新日期:2010-01-20 00:00:00

  • Massage, reflexology and other manual methods for pain management in labour.

    abstract:BACKGROUND:Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain man...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009290.pub3

    authors: Smith CA,Levett KM,Collins CT,Dahlen HG,Ee CC,Suganuma M

    更新日期:2018-03-28 00:00:00

  • Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more).

    abstract:BACKGROUND:Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES:The objective of this review is to assess the effects of planned early birth (immediate ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005302.pub3

    authors: Middleton P,Shepherd E,Flenady V,McBain RD,Crowther CA

    更新日期:2017-01-04 00:00:00

  • Multidisciplinary rehabilitation for adults with multiple sclerosis.

    abstract:BACKGROUND:Multidisciplinary rehabilitation (MD) is an important component of symptomatic and supportive treatment for Multiple sclerosis (MS), but evidence base for its effectiveness is yet to be established. OBJECTIVES:To assess the effectiveness of organized MD rehabilitation in adults with MS. To explore rehabilit...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006036.pub2

    authors: Khan F,Turner-Stokes L,Ng L,Kilpatrick T

    更新日期:2007-04-18 00:00:00

  • Traditional Chinese Medicine herbs for stopping bleeding from haemorrhoids.

    abstract:BACKGROUND:Haemorrhoids is a common perianal disease, which often causes haematochezia. Besides a surgical operation or minimally invasive treatment, a variety of traditional Chinese medicinal herbs (TCMHs) have been used to treat bleeding haemorrhoids. OBJECTIVES:To assess the effectiveness of traditional Chinese med...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006791.pub2

    authors: Gan T,Liu YD,Wang Y,Yang J

    更新日期:2010-10-06 00:00:00

  • Recombinant human erythropoietin for chronic renal failure anaemia in pre-dialysis patients.

    abstract:BACKGROUND:Treatment with recombinant human erythropoietin (rHu EPO) in dialysis patients has been shown to be highly effective in terms of correcting anaemia and improving quality of life. There is debate concerning the benefits of rHu EPO use in pre-dialysis patients. There is a concern that rHu EPO may accelerate th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003266

    authors: Cody J,Daly C,Campbell M,Donaldson C,Grant A,Khan I,Pennington S,Vale L,Wallace S,MacLeod A

    更新日期:2001-01-01 00:00:00

  • Oral calorie supplements for cystic fibrosis.

    abstract:BACKGROUND:Poor nutrition occurs frequently in people with cystic fibrosis (CF) and is associated with other adverse outcomes. Oral calorie supplements are used to increase total daily calorie intake and improve weight gain. However, they are expensive and there are concerns they may reduce the amount of food eaten and...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000406.pub2

    authors: Smyth R,Walters S

    更新日期:2007-01-24 00:00:00

  • Cholinesterase inhibitors for the treatment of delirium in non-ICU settings.

    abstract:BACKGROUND:Delirium is a common clinical syndrome defined as alterations in attention with an additional disturbance in cognition or perception, which develop over a short period of time and tend to fluctuate during the course of the episode. Delirium is commonly treated in hospitals or community settings and is often ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD012494.pub2

    authors: Yu A,Wu S,Zhang Z,Dening T,Zhao S,Pinner G,Xia J,Yang D

    更新日期:2018-06-28 00:00:00

  • Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics.

    abstract:BACKGROUND:Spinal anaesthesia has been in use since the turn of the late 19th century. The most serious complication of this technique is damage to the spinal cord or nerve roots resulting in lasting neurologic sequelae. Such serious adverse effects seldom happen. There has been an increase in the number of reports dur...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003006

    authors: Zaric D,Christiansen C,Pace NL,Punjasawadwong Y

    更新日期:2003-01-01 00:00:00

  • Interventions for patients and caregivers to improve knowledge of sickle cell disease and recognition of its related complications.

    abstract:BACKGROUND:Sickle cell disease is a group of genetic diseases which is especially prevalent in tropical and subtropical regions; however, forced migration and ongoing population movement have spread it throughout the world, with estimated birth rates reaching 0.49 per 1000 in the Americas, 0.07 per 1000 in Europe, 0.68...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011175.pub2

    authors: Asnani MR,Quimby KR,Bennett NR,Francis DK

    更新日期:2016-10-06 00:00:00

  • Propofol for procedural sedation/anaesthesia in neonates.

    abstract:BACKGROUND:Elective medical or surgical procedures are commonplace for neonates admitted to NICU. Agents such as opioids are commonly used for achieving sedation/analgesia/anaesthesia for such procedures; however, these agents are associated with adverse effects. Propofol is used widely in paediatric and adult populati...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007248.pub2

    authors: Shah PS,Shah VS

    更新日期:2011-03-16 00:00:00

  • Antenatal breastfeeding education for increasing breastfeeding duration.

    abstract:BACKGROUND:Breastfeeding (BF) is well recognised as the best food for infants. The impact of antenatal BF education on the duration of BF has not been evaluated. OBJECTIVES:To evaluate the effectiveness of antenatal BF education for increasing BF initiation and duration. SEARCH METHODS:We searched the Cochrane Pregna...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006425.pub2

    authors: Lumbiganon P,Martis R,Laopaiboon M,Festin MR,Ho JJ,Hakimi M

    更新日期:2011-11-09 00:00:00

  • Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings.

    abstract:BACKGROUND:Ageing has a degenerative effect on the skin, leaving it more vulnerable to damage. Hygiene and emollient interventions may help maintain skin integrity in older people in hospital and residential care settings; however, at present, most care is based on "tried and tested" practice, rather than on evidence. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011377.pub2

    authors: Cowdell F,Jadotte YT,Ersser SJ,Danby S,Lawton S,Roberts A,Dyson J

    更新日期:2020-01-23 00:00:00

  • Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.

    abstract:BACKGROUND:Mild-moderate hypertension during pregnancy is common. Antihypertensive drugs are often used in the belief that lowering blood pressure will prevent progression to more severe disease, and thereby improve outcome. OBJECTIVES:To assess the effects of antihypertensive drug treatments for women with mild to mo...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002252

    authors: Abalos E,Duley L,Steyn DW,Henderson-Smart DJ

    更新日期:2001-01-01 00:00:00

  • Interventions for paracetamol (acetaminophen) overdoses.

    abstract:BACKGROUND:Self-poisoning with paracetamol (acetaminophen) is a common cause of hepatotoxicity in the Western World. Interventions for paracetamol poisoning encompass inhibition of absorption, removal from the vascular system, antidotes, and liver transplantation. OBJECTIVES:The objective was to assess the beneficial ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003328

    authors: Brok J,Buckley N,Gluud C

    更新日期:2002-01-01 00:00:00

  • Methods of preventing bacterial sepsis and wound complications after liver transplantation.

    abstract:BACKGROUND:Bacterial sepsis and wound complications after liver transplantation increase mortality, morbidity, or hospital stay and are likely to increase overall transplant costs. All liver transplantation patients receive antibiotic prophylaxis. This is an update of our 2008 Cochrane systematic review on the same top...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006660.pub3

    authors: Gurusamy KS,Nagendran M,Davidson BR

    更新日期:2014-03-05 00:00:00

  • Unconditional cash transfers for assistance in humanitarian disasters: effect on use of health services and health outcomes in low- and middle-income countries.

    abstract:BACKGROUND:Unconditional cash transfers (UCTs) are a common social protection intervention that increases income, a key social determinant of health, in disaster contexts in low- and middle-income countries (LMICs). OBJECTIVES:To assess the effects of UCTs in improving health services use, health outcomes, social dete...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011247.pub2

    authors: Pega F,Liu SY,Walter S,Lhachimi SK

    更新日期:2015-09-11 00:00:00

  • Topical umbilical cord care at birth.

    abstract:BACKGROUND:Umbilical cord infection caused many neonatal deaths before aseptic techniques were used. OBJECTIVES:The objective of this review was to assess the effects of topical cord care in preventing cord infection, illness and death. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group trials re...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001057

    authors: Zupan J,Garner P

    更新日期:2000-01-01 00:00:00

  • Single dose oral etoricoxib for acute postoperative pain in adults.

    abstract:BACKGROUND:Etoricoxib is a selective cyclo-oxygenase-2 (COX-2) inhibitor prescribed for the relief of chronic pain in osteoarthritis and rheumatoid arthritis, and acute pain. The drug is believed to be associated with fewer upper gastrointestinal adverse effects than conventional non-steroidal anti-inflammatory drugs (...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004309.pub2

    authors: Clarke R,Derry S,Moore RA,McQuay HJ

    更新日期:2009-04-15 00:00:00

  • Single dose oral indometacin for the treatment of acute postoperative pain.

    abstract:BACKGROUND:Indometacin is a non-steroidal anti-inflammatory drug (NSAID) used most commonly for the treatment of inflammation and pain resulting from rheumatic disease (arthritis), and less commonly in postoperative pain management. When taken for chronic pain conditions, indometacin has been associated with a high inc...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004308.pub2

    authors: Mason L,Edwards J,Moore RA,McQuay HJ

    更新日期:2004-10-18 00:00:00

  • Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: a qualitative evidence synthesis.

    abstract:BACKGROUND:Having nurses take on tasks that are typically conducted by doctors (doctor-nurse substitution, a form of 'task-shifting') may help to address doctor shortages and reduce doctors' workload and human resource costs. A Cochrane Review of effectiveness studies suggested that nurse-led care probably leads to sim...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD010412.pub2

    authors: Karimi-Shahanjarini A,Shakibazadeh E,Rashidian A,Hajimiri K,Glenton C,Noyes J,Lewin S,Laurant M,Colvin CJ

    更新日期:2019-04-15 00:00:00

  • Prosthetic rehabilitation for older dysvascular people following a unilateral transfemoral amputation.

    abstract:BACKGROUND:Dysvascularity accounts for 75% of all lower limb amputations in the UK. Around 37% of these are at transfemoral level (mid-thigh), with the majority of people being over the age of 60 and having existing co-morbidities. A significant number of these amputees will be prescribed a lower limb prosthesis for wa...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005260.pub2

    authors: Cumming JC,Barr S,Howe TE

    更新日期:2006-10-18 00:00:00

  • Rivastigmine for vascular cognitive impairment.

    abstract:BACKGROUND:Vascular dementia represents the second most common type of dementia. The classification of vascular dementia broadly follows three clinico-pathological processes: multi-infarct dementia, single strategic infarct dementia and subcortical dementia. As not all victims fulfil strict criteria for dementia and ma...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004744.pub2

    authors: Craig D,Birks J

    更新日期:2005-04-18 00:00:00

  • Physical training for asthma.

    abstract:BACKGROUND:Physical training programmes have been designed for asthmatic subjects with the aim of improving physical fitness, neuromuscular coordination and self-confidence. Habitual physical activity increases physical fitness and lowers ventilation during mild and moderate exercise thereby reducing the likelihood of ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001116.pub2

    authors: Ram FS,Robinson SM,Black PN,Picot J

    更新日期:2005-10-19 00:00:00

  • WITHDRAWN: Proton pump inhibitor treatment for acute peptic ulcer bleeding.

    abstract:BACKGROUND:Randomised controlled trials (RCTs) evaluating the clinical effect of proton pump inhibitors (PPIs) in peptic ulcer (PU) bleeding yield conflicting results. OBJECTIVES:To evaluate the efficacy of PPIs in acute bleeding from PU using evidence from RCTs. SEARCH STRATEGY:We searched CENTRAL, The Cochrane Libr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002094.pub4

    authors: Leontiadis GI,Sharma VK,Howden CW

    更新日期:2010-05-12 00:00:00

  • Antibiotics for treating osteomyelitis in people with sickle cell disease.

    abstract:BACKGROUND:Osteomyelitis (both acute and chronic) is one of the most common infectious complications in people with sickle cell disease. There is no standardized approach to antibiotic therapy and treatment is likely to vary from country to country. Thus, there is a need to identify the efficacy and safety of different...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007175.pub3

    authors: Martí-Carvajal AJ,Agreda-Pérez LH

    更新日期:2012-12-12 00:00:00

  • Iron supplementation in pregnancy.

    abstract:BACKGROUND:Anaemia in pregnancy is a major health problem in many developing countries where nutritional deficiency, malaria and other parasitic infections contribute to increased maternal and perinatal mortality and morbidity. OBJECTIVES:The objective of this review was to assess the effects of iron supplementation o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000117

    authors: Mahomed K

    更新日期:2000-01-01 00:00:00