The effect of ursodeoxycholic acid treatment on survival and liver histological progression of primary biliary cirrhosis remains uncertain.
Dr Wei-fen Xie and colleagues from China assessed the long-term efficacy of mid-dose ursodeoxycholic acid treatment for primary biliary cirrhosis.
Electronic databases including Medline, Embase, Cochrane controlled trials register, Science Citation Index, PUBMED up to 2005 were searched.
The research team also conducted manual bibliographical searches.
A meta-analysis of all long-term randomized controlled trials comparing mid-dose ursodeoxycholic acid with placebo or no treatment was performed.
The team identified 7 trials and 6 reports of their extended follow-up including 1038 patients.
|7 trials showed a reduction of the incidence of liver transplantation|
|American Journal of Gastroenterology|
The researchers found that ursodeoxycholic acid could significantly improve liver biochemistry, but had no effect on pruritus and fatigue.
Ursodeoxycholic acid could delay the progression of primary biliary cirrhosis, especially for early-stage patients.
Meta-analysis of the 7 trials including their extended follow-up showed a significant reduction of the incidence of liver transplantation.
The team also noted a marginally significant reduction of the rate of death or liver transplantation in the ursodeoxycholic acid group, except death.
A sensitivity analyses included studies administrating placebo as control, long-term studies, or large size studies.
The researchers found that long-term treatment with ursodeoxycholic acid could reduce the incidence of liver transplantation, and death or liver transplantation.
Dr Xie's team concludes, “Long-term treatment with mid-dose ursodeoxycholic acid can improve liver biochemistry and survival free of liver transplantation in patients with primary biliary cirrhosis.”
“In addition, ursodeoxycholic acid therapy can delay the histological progression in the early-stage patients.”