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Ursodeoxycholic acid treats intrahepatic cholestasis of pregnancy

A study in December's issue of Gastroenterology examines the efficacy of ursodeoxycholic acid in treating intrahepatic cholestasis of pregnancy.

News image

We performed a meta-analysis to evaluate the effects of ursodeoxycholic acid on pruritus, liver test results, and outcomes of babies born to women with intrahepatic cholestasis of pregnancy intrahepatic cholestasis of pregnancy.

Dr Yannick Bacq and colleagues from France performed a systematic review of 9 published, randomized controlled trials that compared the effects of ursodeoxycholic acid to other drugs, placebo, or no specific treatment in patients with intrahepatic cholestasis of pregnancy.

The researchers analyzed data from 454 patients, of which 207 received only ursodeoxycholic acid, 70 received only placebo, 42 received cholestyramine, 36 received dexamethasone for 1 week and then placebo for 2 weeks, 65 received S-adenosyl-methionine, and 
 
The team reported that 34 patients received no specific treatment. 
 
The team sent a standard questionnaire to all corresponding authors.
Ursodeoxycholic acid was associated with total resolution of pruritus
Gastroenterology
 
For each end point, the team performed pooled analysis that compared the effects of ursodeoxycholic acid with those of all controls and ursodeoxycholic acid with those of placebos.
 
The researchers found that ursodeoxycholic acid was associated with total resolution of pruritus, reduced pruritis, normalization of serum levels of alanine aminotransferase, decreased serum level of alanine aminotransferase, reduced serum levels of bile acids, fewer premature births, reduced fetal distress, less frequent respiratory distress syndrome, and fewer neonates in the intensive 
care unit.

In pooled analyses that compared the effects of ursodeoxycholic acid with placebo, ursodeoxycholic acid reduced pruritus, normalized or decreased serum levels of alanine aminotransferase, and reduced serum levels of bile acids.

Dr Yannick's team concludes,  "Based on a meta-analysis, ursodeoxycholic acid is effective in reducing pruritus and improving liver test results in patients with intrahepatic cholestasis of pregnancy."
 
"Ursodeoxycholic acid therapy might also benefit fetal outcomes."

Gastroenterol 2012: 143(6): 1492-1501

05 December 2012

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