Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis

Paul Angulo, Kenneth P. Batts, Terry M Therneau, Roberta A. Jorgensen, E. Rolland Dickson, Keith D. Lindor

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease frequently leading to development of cirrhosis and its complications. Ursodeoxycholic acid (UDCA) is a beneficial medical therapy for patients with PBC. Improvement in some histological features, but not in histological stage, has been reported after 2 years of UDCA therapy. Thus, longer follow- up may be necessary to determine whether UDCA has a favorable effect on histological stage of disease and progression to cirrhosis. Our aim was to determine the long-term effects of UDCA therapy on histological stage and progression to cirrhosis in patients with PBC. Sixteen unselected patients with noncirrhotic PBC who had been on long-term UDCA therapy (13-15 mg/kg/d) for 6.6 ± 0.4 years (range, 5-9 years) were identified and their histological finding during treatment compared with that of 51 noncirrhotic patients with PBC who had received ineffective therapy (D-penicillamine [DPCA] or placebo) for 5.6 ± 0.07 years (range, 5-8 years). Histological stage was determined using the Ludwig classification. The rate of progression to cirrhosis (stage 4) was significantly less in the UDCA group than in the control group (13% vs. 49%; P = .009). Although the overall rate of progression of histological stage was less in the UDCA group than in the control group (50% vs. 71%), this difference was not significant (P = .1). A marked improvement in liver biochemistries and Mayo risk score was noted in all patients during UDCA therapy; however, this improvement was not significantly different between patients who progressed and those who did not. In conclusion, long-term UDCA therapy appeared to delay the development of cirrhosis in PBC.

Original languageEnglish (US)
Pages (from-to)644-647
Number of pages4
JournalHepatology
Volume29
Issue number3
StatePublished - 1999

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Ursodeoxycholic Acid
Biliary Liver Cirrhosis
Fibrosis
Therapeutics
Control Groups
Penicillamine
Biochemistry
Disease Progression
Liver Diseases
Placebos

ASJC Scopus subject areas

  • Hepatology

Cite this

Angulo, P., Batts, K. P., Therneau, T. M., Jorgensen, R. A., Rolland Dickson, E., & Lindor, K. D. (1999). Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis. Hepatology, 29(3), 644-647.

Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis. / Angulo, Paul; Batts, Kenneth P.; Therneau, Terry M; Jorgensen, Roberta A.; Rolland Dickson, E.; Lindor, Keith D.

In: Hepatology, Vol. 29, No. 3, 1999, p. 644-647.

Research output: Contribution to journalArticle

Angulo, P, Batts, KP, Therneau, TM, Jorgensen, RA, Rolland Dickson, E & Lindor, KD 1999, 'Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis', Hepatology, vol. 29, no. 3, pp. 644-647.
Angulo P, Batts KP, Therneau TM, Jorgensen RA, Rolland Dickson E, Lindor KD. Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis. Hepatology. 1999;29(3):644-647.
Angulo, Paul ; Batts, Kenneth P. ; Therneau, Terry M ; Jorgensen, Roberta A. ; Rolland Dickson, E. ; Lindor, Keith D. / Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis. In: Hepatology. 1999 ; Vol. 29, No. 3. pp. 644-647.
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N2 - Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease frequently leading to development of cirrhosis and its complications. Ursodeoxycholic acid (UDCA) is a beneficial medical therapy for patients with PBC. Improvement in some histological features, but not in histological stage, has been reported after 2 years of UDCA therapy. Thus, longer follow- up may be necessary to determine whether UDCA has a favorable effect on histological stage of disease and progression to cirrhosis. Our aim was to determine the long-term effects of UDCA therapy on histological stage and progression to cirrhosis in patients with PBC. Sixteen unselected patients with noncirrhotic PBC who had been on long-term UDCA therapy (13-15 mg/kg/d) for 6.6 ± 0.4 years (range, 5-9 years) were identified and their histological finding during treatment compared with that of 51 noncirrhotic patients with PBC who had received ineffective therapy (D-penicillamine [DPCA] or placebo) for 5.6 ± 0.07 years (range, 5-8 years). Histological stage was determined using the Ludwig classification. The rate of progression to cirrhosis (stage 4) was significantly less in the UDCA group than in the control group (13% vs. 49%; P = .009). Although the overall rate of progression of histological stage was less in the UDCA group than in the control group (50% vs. 71%), this difference was not significant (P = .1). A marked improvement in liver biochemistries and Mayo risk score was noted in all patients during UDCA therapy; however, this improvement was not significantly different between patients who progressed and those who did not. In conclusion, long-term UDCA therapy appeared to delay the development of cirrhosis in PBC.

AB - Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease frequently leading to development of cirrhosis and its complications. Ursodeoxycholic acid (UDCA) is a beneficial medical therapy for patients with PBC. Improvement in some histological features, but not in histological stage, has been reported after 2 years of UDCA therapy. Thus, longer follow- up may be necessary to determine whether UDCA has a favorable effect on histological stage of disease and progression to cirrhosis. Our aim was to determine the long-term effects of UDCA therapy on histological stage and progression to cirrhosis in patients with PBC. Sixteen unselected patients with noncirrhotic PBC who had been on long-term UDCA therapy (13-15 mg/kg/d) for 6.6 ± 0.4 years (range, 5-9 years) were identified and their histological finding during treatment compared with that of 51 noncirrhotic patients with PBC who had received ineffective therapy (D-penicillamine [DPCA] or placebo) for 5.6 ± 0.07 years (range, 5-8 years). Histological stage was determined using the Ludwig classification. The rate of progression to cirrhosis (stage 4) was significantly less in the UDCA group than in the control group (13% vs. 49%; P = .009). Although the overall rate of progression of histological stage was less in the UDCA group than in the control group (50% vs. 71%), this difference was not significant (P = .1). A marked improvement in liver biochemistries and Mayo risk score was noted in all patients during UDCA therapy; however, this improvement was not significantly different between patients who progressed and those who did not. In conclusion, long-term UDCA therapy appeared to delay the development of cirrhosis in PBC.

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