Treatment of Radiolucent Gallstones with CDCA or UDCA

Polli, E.

doi:10.1159/000198643

Cited by 21 publications

(10 citation statements)

References 11 publications

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“…No serious adverse effects of UDCA administration were reported in early controlled clinical trials in patients with gallstone disease, [56][57][58][59] or in long-term, large-scale, placebo-controlled trials in patients with cholestatic liver disease. [11][12][13][14]16 A recent Cochrane review on UDCA in primary biliary cirrhosis revealed that there was no significant increase in total adverse events or severe adverse events in 10 controlled clinical trials.…”

Section: Adverse Effectsmentioning

confidence: 99%

Ursodeoxycholic acid — adverse effects and drug interactions

Hempfling¹,

Dilger

Beuers³

2003

Aliment Pharmacol Ther

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SUMMARYBackground: Ursodeoxycholic acid is increasingly being used for the treatment of chronic cholestatic liver diseases. It appears to be generally well tolerated, but a systematic review on drug safety is lacking. Aim: As experimental data suggest a role of bile acids in the regulation of hepatic drug metabolism at both the transcriptional and post-transcriptional level, the literature was screened for adverse drug reactions and drug interactions related to ursodeoxycholic acid. Methods: A systematic review of the literature was performed using a refined search strategy to evaluate the adverse effects of ursodeoxycholic acid and its interactions with other drugs. Results: Ursodeoxycholic acid caused diarrhoea in a small proportion of patients. Rare skin reactions were

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Section: Adverse Effectsmentioning

confidence: 99%

Ursodeoxycholic acid — adverse effects and drug interactions

Hempfling¹,

Dilger

Beuers³

2003

Aliment Pharmacol Ther

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“…32 We have also shown that bedtime administration of CDCA is more effective than mealtime administration in improving the gall stone dissolution rate. 33 Previous studies have expressed their results in terms of the percentage of patients who achieve partial or complete gall stone dissolution, or both, within a defined time.22-24 26 28 12 34 The disadvantage ofthese studies is that only those patients who achieved complete dissolution are used for statistical analysis, and therefore there is a requirement for large numbers of patients to be enrolled, or for long periods of treatment follow up. This has prevented the demonstration of clearcut differences between the two bile acids.…”

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confidence: 99%

Optimum bile acid treatment for rapid gall stone dissolution.

Jazrawi

Pigozzi

Galatola

et al. 1992

Gut

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To determine the optimum bile acid regimen for rapid gail stone dissolution, 48 gall stone patients were divided into four groups of 12 according to stone diameter and were randomly allocated to receive one of four treatment regimens: bedtime or mealtime chenodeoxycholic acid (CDCA, 12 mg/kg/day) and bedtime or mealtime ursodeoxycholic acid (UDCA, 12 mg/kg/day). An additional 10 patients treated with a combination of CDCA plus UDCA (each 6 mg/kg/day) at bedtime were matched with the 10 patients on bedtime CDCA and the 10 on bedtime UDCA. The gall stone dissolution rates at six and 12 months were determined by standardised oral cholecystography and expressed as the percentage reduction in the gall stone volume after treatment. The gall stone dissolution rate at six months was higher for UDCA than CDCA treatment (median 78% v 48%, p<001), and for bedtime than mealtime administration (69% v 39%, p<002). Both differences were greater for stones <8 mm diameter. The dissolution rate was faster for combination therapy than for CDCA alone at both six (82% v 36%, p<0O05) and 12 months (100% v 54%, p<005), but was not different from UDCA alone. We conclude that bile acid treatment should be confined to patients with smail gail stones and that bedtime administration of combined UDCA and CDCA is likely to provide the most effective and safe combination.

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“…Urso treatment leads to dissolution of cholesterol gallstones in man (1)(2)(3)(4)(5)(6)(7)(8)(9). Oral administration of Urso increases Urso in bile and decreases the biliary cholesterol (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

mentioning

confidence: 99%

Effect of Ursodeoxycholic Acid on Biliary Bile Acid and Bile Lipid Composition in Gallstone Patients

Stiehl¹,

Raedsch²,

Rudolph³

et al. 1984

Hepatology

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In five patients with radiolucent gallstones, the effect of ursodeoxycholic acid (Urso) in doses of 250, 500, 750, 1,000, and 1,250 mg per day on biliary lipid and bile acid composition was studied. Biliary cholesterol decreased from 8.8 +/- 0.8 mole% to 4.4 +/- 0.2 mole% at 500 mg Urso per day (7.1 mg per kg) and to 4.2 +/- 0.3 mole% at 750 mg Urso per day (10.7 mg per kg). Administration of 1,000 or 1,250 mg Urso per day produced no further decrease of biliary cholesterol. The biliary content of phospholipids and total bile acids remained unchanged. During Urso treatment, the relative amounts of glyco-Urso and tauro-Urso in bile increased. Glyco-Urso reached a plateau at 49.1 +/- 2.1% of total bile acids during treatment with 1,000 mg Urso per day, and tauro-Urso increased up to 4.3 +/- 1.5% of total bile acids at 250 mg Urso per day. Simultaneously cholic acid, chenodeoxycholic acid, deoxycholic acid, and lithocholic acid decreased. The data indicate that Urso treatment reduces biliary cholesterol efficiently already at a dose of 500 mg per day; biliary bile acid composition changes up to 1,000 mg Urso per day. Doses greater than 1,000 mg per day produced no additional alterations in bile composition.

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Treatment of Radiolucent Gallstones with CDCA or UDCA

Cited by 21 publications

References 11 publications

Ursodeoxycholic acid — adverse effects and drug interactions

Ursodeoxycholic acid — adverse effects and drug interactions

Optimum bile acid treatment for rapid gall stone dissolution.

Effect of Ursodeoxycholic Acid on Biliary Bile Acid and Bile Lipid Composition in Gallstone Patients

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