Effects of ursodeoxycholic acid (UDCA) on serum liver damage indices in patients with chronic active hepatitis

Abstract

The effects of ursodeoxycholic acid (UDCA, 450 mg daily) in patients with histologically proven chronic active hepatitis (CAH) have been evaluated in a randomized, double-blind, placebo-controlled study. Twenty-six patients with serum alanine aminotransferase (ALT) values at least twice the normal upper limit in two of three pre-treatment tests received UDCA or a placebo for twelve weeks. In all UDCA-treated patients, serum aspartate amino-transferase (AST), ALT, gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (AP) fell significantly after 4 weeks of treatment. There was a further decrease at the end of therapy, as well as a small but significant fall in total serum bilirubin. Conversely, 4 weeks after suspension of therapy, serum enzyme levels had increased, reaching values not much lower than those recorded before treatment. Total serum protein, albumin and gamma-globulin did not change after UDCA treatment. In the placebo group no significant variation in the test results were found. The results indicate that UDCA therapy in CAH, as has been observed in primary biliary cirrhosis and primary sclerosing cholangitis, is able to improve several indices of liver damage, without producing any toxic adverse effects.

Bezafibrate may attenuate biliary damage associated with chronic liver diseases accompanied by high serum biliary enzyme levels

“…However, the efficacy of UDCA for attenuating hepatobiliary damages seemed beyond doubt, and several studies have demonstrated the efficacy of UDCA in this respect. 24,25 There was no statistically significant difference in the ratio of reduction in ALP levels between the group that received prior treatment with UDCA and that which did not ( Table 2). The main mechanism by which UDCA lowers serum biliary enzyme levels is thought to be the replacement of toxic bile salts with nontoxic hydrophobic ones, which differs from the mechanism of bezafibrate, as mentioned earlier.…”

A two-year prospective study of the effect of ursodeoxycholic acid on urinary bile acid excretion and liver morphology in cystic fibrosis-associated liver disease

“…[7][8][9] In primary biliary cirrhosis, an improved survival rate and liver morphology have been shown. 8,10 In CF, UDCA has been shown to improve LFT and to ameliorate the hepatic wash-out of isotope at hepatobiliary scintigraphy.…”

Non‐interferon‐based therapy: an option for amelioration of necro‐inflammation in hepatitis C patients who cannot afford interferon therapy

“…It reduces the effect of hydrophobic bile acids on the hepatocytes through its choleritic and anti‐apoptotic effects (12). In addition, it decreases hepatitis C virus‐related hepatic injury by modifying the expression of HLA‐Class I and reinforces the natural antiviral mechanisms such as natural killer cells, 2″, 5″ oligo adenylate synthetase activity thus degrading viral mRNA (13, 14). UDCA was shown to achieve normalization of serum transaminases twice as much as amantadine hydrochloride or silymarin (15).…”