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A dose-up of ursodeoxycholic acid decreases transaminases in hepatitis C patients

Shuichi Sato1, Tatsuya Miyake, Hiroshi Tobita

  • 1Department of Gastroenterology and Hepatology, Shimane University, School of Medicine, Izumo, Shimane, Japan. bbsato@med.shimane-u.ac.jp

World Journal of Gastroenterology
|June 13, 2009
PubMed

Insights

Increasing ursodeoxycholic acid (UDCA) to 900 mg daily significantly reduced liver enzymes like ALT and AST in hepatitis C patients. This higher UDCA dose proved more effective than 600 mg daily for managing liver inflammation.

Area of Science:

  • Hepatology
  • Viral Hepatitis
  • Pharmacology

Background:

  • Hepatitis C virus (HCV) infection can lead to chronic liver disease and cirrhosis.
  • Ursodeoxycholic acid (UDCA) is used in liver disease management, but optimal dosing for HCV requires further investigation.
  • Elevated transaminases (ALT, AST, GGT) are markers of liver injury in chronic hepatitis C.

Purpose of the Study:

  • To evaluate the efficacy of increasing ursodeoxycholic acid (UDCA) dosage to 900 mg/day in reducing liver enzyme levels in patients with hepatitis C.
  • To compare the effectiveness of 900 mg/day UDCA versus 600 mg/day UDCA in managing HCV-related liver disease.

Main Methods:

  • A study involving patients aged 43-80 with chronic hepatitis C or compensated liver cirrhosis and positive HCV-RNA.
  • Patients previously on 600 mg/day UDCA had their dosage increased to 900 mg/day.
  • Blood parameters including ALT, AST, and GGT were measured at baseline and at 4, 8, and 24 weeks post-dose escalation.

Main Results:

  • A statistically significant decrease in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT) levels was observed after increasing UDCA to 900 mg/day.
  • The mean reduction in ALT was 14.3 IU/L, AST was 10.5 IU/L, and GGT was 9.8 IU/L at 8 weeks post-dose increase.
  • A trend towards increased platelet count was noted, though not statistically significant. Minor adverse events occurred in 3 patients without study dropouts.

Conclusions:

  • A daily oral dose of 900 mg UDCA is more effective than 600 mg/day for reducing ALT, AST, and GGT levels in patients with HCV-related chronic liver disease.
  • Higher-dose UDCA demonstrates potential as an adjunctive therapy for managing liver inflammation in hepatitis C.
  • The safety profile of increased UDCA dosage appears favorable in this patient cohort.
Abstract

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