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Review of historical cohort: ursodeoxycholic acid in extrahepatic biliary atresia
1Department of Pediatrics, Cairo University, PO Box, 85 El Mokatam, Cairo 11571, Egypt. magdkotb@hotmail.com
Insights
Ursodeoxycholic acid did not improve outcomes in infants with extrahepatic biliary atresia. Its use was linked to complications, suggesting it is not effective for this condition.
Area of Science:
- Pediatric Hepatology
- Gastroenterology
- Bile Acid Research
Background:
- Ursodeoxycholic acid (UDCA) is a bile acid known to increase bile flow, protect liver cells (hepatocytes), and dissolve gallstones.
- Extrahepatic biliary atresia is a serious condition affecting infants, often requiring surgical intervention like Kasai portoenterostomy.
Purpose of the Study:
- To evaluate the efficacy and safety of ursodeoxycholic acid in infants and children diagnosed with extrahepatic biliary atresia.
- To review the impact of UDCA on treatment outcomes following Kasai portoenterostomy.
Main Methods:
- A statistical analysis was performed on patient records of infants and children with extrahepatic biliary atresia.
- Data were collected from patients who underwent Kasai portoenterostomy and attended the Hepatology Clinic at New Children's Hospital, Cairo University, Egypt, between May 1985 and June 2005.
Main Results:
- Out of 141 infants, 108 received ursodeoxycholic acid (20 mg/kg/day) for a mean duration of 252.6 days.
- Infants receiving UDCA showed a lower successful outcome rate (10.18%) compared to those not receiving it (24.2%) (P = .043).
- Age under 65 days at portoenterostomy was a predictor of success, while UDCA intake was associated with a lower likelihood of successful outcomes (P = .04).
Conclusions:
- Ursodeoxycholic acid was not effective in improving outcomes for infants with extrahepatic biliary atresia in this cohort.
- The use of UDCA was associated with numerous hepatic and extrahepatic complications, questioning its therapeutic benefit.
Background:
Ursodeoxycholic acid is a bile acid that was found to increase bile flow, protect hepatocytes, and dissolve gallstones.
Purpose:
The objective of this study is to review ursodeoxycholic acid in infants and children with extrahepatic biliary atresia.
Methods:
We used a statistical analysis of data of records of infants and children having extrahepatic biliary atresia who underwent Kasai portoenterostomy and attended Hepatology Clinic, New Children's Hospital, Cairo University, Egypt, from May 1985 until June 2005.
Results:
Of 141 infants with extrahepatic biliary atresia, 108 received ursodeoxycholic acid for mean duration +/- SD of 252.6 +/- 544.9 days in a dosage of 20 mg/kg per day. The outcome of infants who did not receive ursodeoxycholic acid and those who did was the following: 8 (24.2%) and 11 (10.18%) had a successful outcome (P = .043), 0 (0%) and 7 (6.4%) improved (P = .148), 25 (75.7%) and 84 (77.7%) had a failed outcome (P = .489), and none vs 5 died (4.6%) (P = .135), respectively. The predictors of successful outcomes were age less than 65 days at portoenterostomy (P = .008) and absence of ursodeoxycholic acid intake (P = .04) with a likelihood of a successful outcome that was 2.8, that associated with ursodeoxycholic acid intake.
Conclusion:
In this cohort of infants with extrahepatic biliary atresia, ursodeoxycholic acid was not shown to be effective, and its use was associated with a plethora of hepatic and extrahepatic complications.