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Ursodeoxycholic acid for nonalcoholic steatohepatitis
Sheng-di Wu1, Lei Li, Ji-yao Wang
1Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
European Journal of Gastroenterology & Hepatology
|August 7, 2012
Summary
Ursodeoxycholic acid monotherapy shows no substantial benefit for nonalcoholic steatohepatitis (NASH). While it reduced lobular inflammation and gamma-glutamyl transpeptidase, it also increased total bilirubin and potentially worsened fibrosis.
Area of Science:
- Hepatology
- Pharmacology
- Gastroenterology
Background:
- Nonalcoholic steatohepatitis (NASH) is a progressive liver disease with limited treatment options.
- Ursodeoxycholic acid (UDCA) is a bile acid with anti-inflammatory and cytoprotective properties, investigated for NASH treatment.
Purpose of the Study:
- To evaluate the efficacy and safety of ursodeoxycholic acid (UDCA) as monotherapy for nonalcoholic steatohepatitis (NASH) through a meta-analysis of randomized controlled trials.
Main Methods:
- A systematic literature search was conducted across multiple databases (PubMed, EMBASE, Web of Science, Cochrane Library, CNKI).
- Included were randomized controlled trials (RCTs) with liver biopsy confirmation of NASH.
- Data from three eligible RCTs were meta-analyzed to assess histological and biochemical outcomes.
Main Results:
- High-dose UDCA significantly improved lobular inflammation (MD: -0.23) but showed a trend towards increased fibrosis (MD: 0.08).
- UDCA significantly reduced gamma-glutamyl transpeptidase (GGT) levels (MD: -35.58), particularly at high doses.
- Serum total bilirubin increased in the high-dose UDCA group (MD: 0.43), while other liver enzymes (ALT, AST, ALP) showed no significant changes. Adverse events were minor.
Conclusions:
- Ursodeoxycholic acid monotherapy does not demonstrate substantial positive effects on nonalcoholic steatohepatitis (NASH) histological outcomes.
- While UDCA may improve certain biochemical markers like GGT, its potential to increase bilirubin and possibly worsen fibrosis warrants caution.
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