Related Experiment Videos
Steroid and ursodesoxycholic Acid combination therapy in severe drug-induced liver injury
Alexander Wree1, Alexander Dechêne, Kerstin Herzer
1Department of Gastroenterolgy and Hepatology, University Hospital Essen, Essen, Germany.
Background:
Drug-induced liver injury (DILI) is the leading cause of acute severe liver disease in Western countries. Treatment strategies for DILI are still not well defined.
Aim:
We studied the safety and outcomes of steroid/ursodesoxycholic acid (UDCA) combination therapy in DILI patients.
Patients, Materials And Methods:
15 consecutive patients with severe DILI were analyzed for clinical, biochemical and histological data. Nine patients were treated with a steroid step-down therapy with reduction of the daily dose over several weeks; 6 patients received a steroid pulse therapy for 3 days. UDCA was administered for several weeks in both groups.
Results:
Patients without histological signs of preexistent liver damage (n = 10) showed the most favorable clinical course. Bilirubin and serum transaminases dropped to <50% of peak values within 2 weeks, and normalized within 4-8 weeks. In contrast, patients with positive autoimmune antibodies (anti-nuclear antibodies and/or soluble liver antigen) and/or histological features of chronic hepatitis (n = 3) exhibited a slower reduction in bilirubin and serum transaminase levels. These patients were given immunosuppressants (steroids, azathioprine) for a further 6 months.
Conclusion:
Treatment of severe DILI with corticosteroids (both pulse and step-down therapy) and UDCA appears to be safe, and leads to a more rapid reduction in bilirubin and transaminases after DILI.
Related Concept Videos
Drugs for Treatment of Ulcerative Colitis in IBD
Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...