Navigation Links
Study finds adverse effects in treatment for primary sclerosing cholangitis
Date:8/19/2009

Primary sclerosing cholangitis (PSC) is an uncommon chronic liver disease characterized by progressive inflammation and destruction of the bile ducts. The disease progresses slowly, usually leading to biliary cirrhosis, portal hypertension and liver failure over a 10-15 year period. PSC is a common cause of adult cholestatic liver diseases and a primary source behind many of the liver transplantations in U.S. adults. At least 70% of PSC cases are associated with chronic inflammatory bowel disease (IBD), usually ulcerative colitis. Currently, there is no cure for PSC and prospective treatments remain ineffective.

A recently ceased study, led by Keith Lindor, M.D., from the Fiterman Center for Digestive Diseases at the Mayo Clinic, determined that PSC patients treated with high-dose Ursodeoxycholic Acid (UDCA) had poorer clinical results compared to those not receiving the therapy. More patients developed esophageal or gastric varices (enlarged veins), died, or became eligible for liver transplantation in the group receiving UDCA compared to the placebo group despite improvement in liver tests. Findings from this study are published in Hepatology, a journal of the American Association for the Study of Liver Diseases.

One hundred fifty adult PSC patients entered the study at seven U.S. sites over a three-year period. Half of the participants in the double-blind controlled trial were given high-dose UDCA (28-30 mg/kg/day), while the others received a placebo. Liver biopsy and imaging of the bile ducts were performed to monitor patients' response to the therapy. The primary outcome measure was development of cirrhosis, varices, cholangiocarcinoma-a bile duct cancer, meeting minimal listing criteria for transplant, liver transplantation or death.

"Our results showed patients on UDCA had a 2.1 times greater chance for death, transplantation or meeting minimal listing criteria than for those in the placebo group," explained researchers. Patients treated with UDCA were more likely to suffer serious adverse effects from the therapy then those who did not receive treatment (63% vs. 37%). Previous studies projected UDCA to be a safe and beneficial therapy.

According to researchers, the Food and Drug Administration (FDA) approved a UDCA dose of 13-15 mg/kg/day for patients with primary biliary cirrhosis and those patients did not suffer more adverse effects when treated with higher doses of the drug up to 25 or 30 mg/kg/day. Pilot studies in PSC patients using doses ranging from 17-25 mg/kg/day did not have an increased risk of adversities. "The findings in our study were surprising and quite unanticipated," said Dr. Lindor. "It is unclear how a drug that has a reputation for such safety would have these paradoxical effects in this condition."

Researchers speculate that higher doses of UDCA allowed unabsorbed drug to enter the colon, modifying into hepatotoxic bile acids and recommend further evaluation of this theory. "At this time, UDCA in a dose of 25-30 mg/kg/day should not be used due to the increased risk to PSC patients," advises Dr. Lindor. "We hope a safe and effective therapy for patients with PSC will be developed, but high-dose UDCA cannot be recommended."


'/>"/>

Contact: Dawn Peters
medicalnews@wiley.com
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Study shows carvedilol is effective in preventing variceal bleeding in cirrhotic patients
2. Profiles International Releases New Study Identifying Key Factors for Strategic Workforce Planning
3. Thomson Reuters Study Finds Impact of Recession Easing on U.S. Hospitals
4. Retirees health-care benefits at risk, study warns
5. Lilly Reports on Outcome of Phase III Study of Arzoxifene
6. New study finds links between video-game playing and health risks in adults
7. Gen-Probe Begins U.S. Clinical Study of APTIMA(R) Trichomonas Vaginalis Assay on the TIGRIS(R) System
8. Study shows how to boost value of Alzheimers-fighting compounds
9. Low-income kids report first sexual intercourse at 12 years old in new national study
10. Excessive exercise can be addicting, new study says
11. New study expands the list of hazardous chemicals in smokeless tobacco
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/28/2017)... ... May 28, 2017 , ... Florida Pain ... announce that Sheldon K. Cho, MD, has joined its Winter Haven practice. ... concentrates on minimally invasive techniques to treat and manage many types of pain. ...
(Date:5/27/2017)... (PRWEB) , ... May 27, 2017 , ... From May ... and Oticon. The three-day event was held at the Marriott Syracuse Downtown Hotel in ... the hearing brand and network of independent hearing healthcare providers to help them stay ...
(Date:5/26/2017)... ... May 26, 2017 , ... ... new educational seminar to focus on current legislative activity and the latest regulatory ... at 1 p.m. Sunday, Sept. 10, and will continue through Monday, Sept. 11, ...
(Date:5/26/2017)... , ... May 26, 2017 , ... ... first ever copper, antimicrobial, mesh back 24/7 task chair specifically designed for clinical ... “We are thrilled to partner with Cupron® to provide customers with a ...
(Date:5/26/2017)... (PRWEB) , ... May 26, 2017 , ... Rob Lowe ... An upcoming production of the series is on hiking in American. Viewers can reconnect ... of the great benefits of hiking. , Many consumers have looked for an inventive ...
Breaking Medicine News(10 mins):
(Date:5/8/2017)... MACRA replaces the outdated sustainable growth ... reimbursement. Black Book Research crowdsource-surveyed 8,845 physician practices from ... Market for MIPS Compliance Technology is Booming ... 3 or more clinicians seek to buy Merit-Based Incentive ... magnitude of the changes, the hunt is on for ...
(Date:5/6/2017)... --  Provista , a proven leader in the supply chain ... Jim Cunniff as the company,s new president and ... to Provista, including most recently serving as the president and ... . He assumed his new role with Provista on May ... Provista," says Jody Hatcher , president, Sourcing and Collaboration ...
(Date:5/6/2017)... 5, 2017  Hill-Rom Holdings, Inc. (NYSE: HRC), has ... square feet to its Welch Allyn campus. ... to bring more than 100 new jobs to ... has maintained a significant presence for more than 100 ... positions, a large portion of which will be R&D ...
Breaking Medicine Technology: