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[Bile acids in liver diseases--current indications]

A Stiehl1

  • 1Medizinische Universitätsklinik, Heidelberg.

Therapeutische Umschau. Revue Therapeutique
|October 1, 1995
PubMed
Summary

Ursodeoxycholic acid (UDCA) offers benefits for various cholestatic liver diseases, improving symptoms and lab results. While not a cure, UDCA can help manage conditions and potentially delay liver transplantation.

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Area of Science:

  • Hepatology
  • Gastroenterology
  • Pharmacology

Context:

  • Cholestatic liver diseases encompass a range of conditions characterized by impaired bile flow.
  • Primary biliary cirrhosis, primary sclerosing cholangitis, and cholestasis of pregnancy are key indications for UDCA.
  • The role of UDCA in chronic and alcoholic hepatitis remains uncertain, requiring further investigation.

Purpose:

  • To review the established and potential therapeutic effects of Ursodeoxycholic acid (UDCA) in various liver conditions.
  • To evaluate the efficacy of UDCA in pediatric cholestatic syndromes and post-transplant settings.
  • To clarify the current understanding of UDCA's benefits and limitations in cholestatic diseases.

Summary:

  • UDCA demonstrates clear benefits in primary biliary cirrhosis, primary sclerosing cholangitis, and cholestasis of pregnancy.
  • Evidence suggests UDCA is beneficial for pediatric cholestatic conditions like Byler's syndrome, Alagille's syndrome, and cystic fibrosis-related cholestasis.
  • UDCA's efficacy is uncertain in chronic hepatitis, alcoholic hepatitis, and benign intermittent cholestasis, with observed effects post-transplantation needing confirmation.

Impact:

  • UDCA treatment improves laboratory parameters, symptoms, and liver histology in many cholestatic conditions.
  • It offers a non-curative management strategy, potentially postponing the need for liver transplantation.
  • In specific pediatric cases and certain cholestatic syndromes, UDCA is a crucial therapeutic agent, sometimes requiring co-administration of primary bile acids.

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