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Ursodeoxycholic acid treatment of primary biliary cirrhosis: potential mechanisms of action

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Primary Biliary Cirrhosis

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Abstract

During the past decade, there has been considerable progress in the treatment of chronic cholestatic liver diseases. Ursodeoxycholic acid has emerged as a safe and effective drug for the treatment of primary biliary cirrhosis. At present, it is the only treatment of primary biliary cirrhosis which not only improves serum liver tests1–5 and certain histological features2,5, but also prolongs survival free of liver transplantation6,7. A combined analysis7 of three large randomized controlled trials of ursodeoxycholic acid in primary biliary cirrhosis from France2, the United States4 and Canada3 included 548 patients who were randomized to receive either ursodeoxycholic acid or placebo. Patients treated with ursodeoxycholic acid had significantly improved survival free of liver transplantation. The effect on survival was most pronounced in the subgroup of high-risk patients with a serum bilirubin greater than 3.5 mg/dl. Since, in the French study and in the Canadian study, patients on placebo were offered ursodeoxycholic acid after two years, the true effect of ursodeoxycholic acid treatment on survival is probably greater than demonstrated in the combined analysis.

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Authors
  1. G. Paumgartner
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Editors and Affiliations

  1. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Keith D. Lindor (Professor of Medicine) (Professor of Medicine)

  2. The Toronto Hospital, Western Division, University of Toronto, 399 Bathurst Street, Wing 4-828, Toronto, ONT, M5T 2S8, Canada

    E. Jenny Heathcote (Professor of Medicine) (Professor of Medicine)

  3. Service d’Hepatologie et Gastroenterologie, AP — Hôpital Saint-Antoine, 184, rue Du Faubourg, Saint-Antoine, 75571, Paris, France

    Raoul Poupon (Professor of Medicine) (Professor of Medicine)

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© 1998 Springer Science+Business Media Dordrecht

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Paumgartner, G. (1998). Ursodeoxycholic acid treatment of primary biliary cirrhosis: potential mechanisms of action. In: Lindor, K.D., Heathcote, E.J., Poupon, R. (eds) Primary Biliary Cirrhosis. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4884-9_17

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  • DOI: https://doi.org/10.1007/978-94-011-4884-9_17

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6047-9

  • Online ISBN: 978-94-011-4884-9

  • eBook Packages: Springer Book Archive

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