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Cyclosporin A for primary biliary cirrhosis
Y Gong1, E Christensen, C Gluud
1Copenhagen Trial Unit, Centre for Clinical Intervention Research, Cochrane Hepato-Biliary Group, Rigshospitalet, Dept. 3344, Blegdamsvej 9, Copenhagen, DENMARK, DK-2100. ygong@ctu.rh.dk
The Cochrane Database of Systematic Reviews
|July 20, 2007
Summary
Cyclosporin A did not significantly reduce mortality in primary biliary cirrhosis patients. However, it improved itching and liver enzymes but increased adverse events like renal dysfunction and hypertension.
Area of Science:
- Hepatology
- Immunology
- Clinical Trials
Background:
- Primary biliary cirrhosis (PBC) is a chronic liver disease.
- Cyclosporin A has been investigated for PBC treatment with varied outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of Cyclosporin A in PBC patients.
- To synthesize evidence from randomized clinical trials.
Main Methods:
- Systematic review of randomized clinical trials (RCTs) comparing Cyclosporin A to placebo.
- Searched multiple databases up to June 2006.
- Analyzed outcomes including mortality, liver transplantation, pruritus, fatigue, liver enzymes, and adverse events.
Main Results:
- Three RCTs with 390 patients were included.
- Cyclosporin A did not significantly impact mortality or liver transplantation rates.
- Improvements were noted in pruritus and liver enzymes (ALT, albumin).
- Increased incidence of adverse events, particularly renal dysfunction and hypertension, was observed.
Conclusions:
- No evidence supports Cyclosporin A for delaying death or disease progression in PBC.
- Cyclosporin A is associated with a higher risk of adverse events.
- Use of Cyclosporin A is not recommended outside of clinical trials.
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