Observation on therapeutic efficacy of ursodeoxycholic acid in Chinese patients with primary biliary cirrhosis: a 2-year follow-up study
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- 作者：Jiangyi Zhu (1)
Yongquan Shi (1)
Xinmin Zhou (1)
Zengshan Li (2)
Xiaofeng Huang (2)
Zheyi Han (1)
Jianhong Wang (1)
Ruian Wang (2)
Jie Ding (1)
Kaichun Wu (1)
Ying Han (1)
Daiming Fan (1) - 关键词：primary biliary cirrhosis ; ursodeoxycholic acid ; Chinese ; biochemical response ; therapeutic efficacy
- 刊名：Frontiers of Medicine
- 出版年：2013
- 出版时间：June 2013
- 年：2013
- 卷：7
- 期：2
- 页码：255-263
- 全文大小：548KB
- 参考文献：1. Poupon R. Primary biliary cirrhosis: a 2010 update. J Hepatol 2010; 52(5): 745-58 CrossRef
2. Prince M, Chetwynd A, Newman W, Metcalf JV, James OF. Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis: follow-up for up to 28 years. Gastroenterology 2002; 123(4): 1044-051 CrossRef
3. Jackson H, Solaymani-Dodara M, Card TR, Aithal GP, Logan R, West J. Influence of ursodeoxycholic acid on the mortality and malignancy associated with primary biliary cirrhosis: a population-based cohort study. J Hepatol 2007; 46: S252–S253 CrossRef
4. Poupon R, Chrétien Y, Poupon RE, Ballet F, Calmus Y, Darnis F. Is ursodeoxycholic acid an effective treatment for primary biliary cirrhosis? Lancet 1987; 329(8537): 834-36 CrossRef
5. Lazaridis KN, Talwalkar JA. Clinical epidemiology of primary biliary cirrhosis: incidence, prevalence, and impact of therapy. J Clin Gastroenterol 2007; 41(5): 494-00 CrossRef
6. Poupon RE, Lindor KD, Parés A, Chazouillères O, Poupon R, Heathcote EJ. Combined analysis of the effect of treatment with ursodeoxycholic acid on histologic progression in primary biliary cirrhosis. J Hepatol 2003; 39(1): 12-6 CrossRef
7. Corpechot C, Carrat F, Bonnand AM, Poupon RE, Poupon R. The effect of ursodeoxycholic acid therapy on liver fibrosis progression in primary biliary cirrhosis. Hepatology 2000; 32(6): 1196-199 CrossRef
8. van Os E, van den Broek WW, Mulder PG, te Borg PC, Bruijn JA, van Buuren HR. Depression in patients with primary biliary cirrhosis and primary sclerosing cholangitis. J Hepatol 2007; 46 (6): 1099-103 CrossRef
9. Jones DE, Al-Rifai A, Frith J, Patanwala I, Newton JL. The independent effects of fatigue and UDCA therapy on mortality in primary biliary cirrhosis: results of a 9 year follow-up. J Hepatol 2010; 53(5): 911-17 CrossRef
10. Goldblatt J, Taylor PJ, Lipman T, Prince MI, Baragiotta A, Bassendine MF, James OF, Jones DE. The true impact of fatigue in primary biliary cirrhosis: a population study. Gastroenterology 2002; 122(5): 1235-241 CrossRef
11. Goulis J, Leandro G, Burroughs AK. Randomised controlled trials of ursodeoxycholic-acid therapy for primary biliary cirrhosis: a meta-analysis. Lancet 1999; 354(9184): 1053-060 CrossRef
12. Papatheodoridis GV, Hadziyannis ES, Deutsch M, Hadziyannis SJ. Ursodeoxycholic acid for primary biliary cirrhosis: final results of a 12-year, prospective, randomized, controlled trial. Am J Gastroenterol 2002; 97(8): 2063-070 CrossRef
13. Heathcote EJ. Management of primary biliary cirrhosis. The American association for the study of liver disease practice guidelines. Hepatology 2000; 31(4): 1005-013 CrossRef
14. Selmi C, Bowlus CL, Gershwin ME, Coppel RL. Primary biliary cirrhosis. Lancet 2011; 377(9777): 1600-609 CrossRef
15. Macaluso FS, Licata A, Costantino A, Alessi N, Maida MF, Craxì A, Almasio PL. Natural history of primary biliary cirrhosis: experience from single center in southern Italy. Dig Liver Dis 2012; 44(Supplement 2): S104 CrossRef
16. Corpechot C, Abenavoli L, Rabahi N, Chrétien Y, Andréani T, Johanet C, Chazouillères O, Poupon R. Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis. Hepatology 2008; 48(3): 871-77 CrossRef
17. Parés A, Caballería L, Rodés J. Excellent long-term survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic acid. Gastroenterology 2006; 130(3): 715-20 CrossRef
18. Beuers U, Lindor KD. A major step towards effective treatment evaluation in primary biliary cirrhosis. J Hepatol 2011; 55(6): 1178-180 CrossRef
19. Dilger K, Hohenester S, Winkler-Budenhofer U, Bastiaansen BA, Schaap FG, Rust C, Beuers U. Effect of ursodeoxycholic acid on bile acid profiles and intestinal detoxification machinery in primary biliary cirrhosis and heath. J Hepatol 2012; 57(1): 133-40 CrossRef
20. Duan MQ, Hen F, Wang ZS, Wu ZC, Liu WS. One-year summary report on UDCA treatment for PBC. J Clin Hepatol (Shi Yong Gan Zang Bing Za zhi) 2009; 12: 50-2 (in Chinese)
21. Eriksson LS, Olsson R, Glauman H, Prytz H, Befrits R, Rydén BO, Einarsson K, Lindgren S, Wallerstedt S, Wedén M. Ursodeoxycholic acid treatment in patients with primary biliary cirrhosis. A Swedish multicentre, double-blind, randomized controlled study. Scand J Gastroenterol 1997; 32(2): 179-86 CrossRef
22. Parés A, Caballería L, Rodés J, Bruguera M, Rodrigo L, García-Plaza A, Berenguer J, Rodríguez-Martínez D, Mercader J, Velicia R. Long-term effects of ursodeoxycholic acid in primary biliary cirrhosis: results of a double-blind controlled multicentric trial. J Hepatol 2000; 32(4): 561-66 CrossRef
23. Corpechot C, Chrétien Y, Chazouillères O, Poupon R. Demographic, lifestyle, medical and familial factors associated with primary biliary cirrhosis. J Hepatol 2010; 53(1): 162-69 CrossRef
24. Ma X, Idle JR, Gonzalez FJ. The pregnane X receptor: from bench to bedside. Expert Opin Drug Metab Toxicol 2008; 4(7): 895-08 CrossRef
25. Zollner G, Wagner M, Trauner M. Nuclear receptors as drug targets in cholestasis and drug-induced hepatotoxicity. Pharmacol Ther 2010; 126(3): 228-43 CrossRef
26. Kuiper EM, Hansen BE, de Vries RA, den Ouden-Muller JW, van Ditzhuijsen TJ, Haagsma EB, Houben MH, Witteman BJ, van Erpecum KJ, van Buuren HR; Dutch PBC Study Group. Improved prognosis of patients with primary biliary cirrhosis that have a biochemical response to ursodeoxycholic acid. Gastroenterology 2009; 136(4): 1281-287 CrossRef
27. Corpechot C, Carrat F, Bahr A, Chrétien Y, Poupon RE, Poupon R. The effect of ursodeoxycholic acid therapy on the natural course of primary biliary cirrhosis. Gastroenterology 2005; 128(2): 297-03 CrossRef
28. Wong GL, Hui AY, Wong VW, Chan FK, Sung JJ, Chan HL. A retrospective study on clinical features and prognostic factors of biopsy-proven primary biliary cirrhosis in Chinese patients. Am J Gastroenterol 2005; 100(10): 2205-211 CrossRef
29. Kim WR, Lindor KD, Locke GR 3rd, Therneau TM, Homburger HA, Batts KP, Yawn BP, Petz JL, Melton LJ 3rd, Dickson ER. Epidemiology and natural history of primary biliary cirrhosis in a US community. Gastroenterology 2000; 119(6): 1631-636 CrossRef
30. Locke GR 3rd, Therneau TM, Ludwig J, Dickson ER, Lindor KD. Time course of histological progression in primary biliary cirrhosis. Hepatology 1996; 23(1): 52-6 CrossRef
31. Kuiper EMM, Hansen BE, Lesterhuis W, Robijin RJ, Thijs JC, Engels LG, Koek G, Aparicio MN, Kerbert-Dreteler MJ, van Buuren HR; Dutch PBC Study Group. The long-term effect of ursodeoxycholic acid on laboratory liver parameters in ciochemically non-advanced primary biliary cirrhosis. Clin Res Hepatol Gastroenterol 2011; 35(1): 29-3 CrossRef
32. Corpechot C, Chazouillères O, Poupon R. Early primary biliary cirrhosis: biochemical response to treatment and prediction of longterm outcome. J Hepatol 2011; 55(6): 1361-367 CrossRef
33. Donaldson PT, Baragiotta A, Heneghan MA, Floreani A, Venturi C, Underhill JA, Jones DE, James OF, Bassendine MF. HLA class II alleles, genotypes, haplotypes, and amino acids in primary biliary cirrhosis: a large-scale study. Hepatology 2006; 44(3): 667-74 CrossRef
34. Hirschfield GM, Liu X, Xu C, Lu Y, Xie G, Lu Y, Gu X, Walker EJ, Jing K, Juran BD, Mason AL, Myers RP, Peltekian KM, Ghent CN, Coltescu C, Atkinson EJ, Heathcote EJ, Lazaridis KN, Amos CI, Siminovitch KA. Primary biliary cirrhosis associated with HLA, IL12A, and IL12RB2 variants. N Engl J Med 2009; 360(24): 2544-555 CrossRef
35. Ala A, Stanca CM, Bu-Ghanim M, Ahmado I, Branch AD, Schiano TD, Odin JA, Bach N. Increased prevalence of primary biliary cirrhosis near Superfund toxic waste sites. Hepatology 2006; 43(3): 525-31 CrossRef
36. Howel D, Fischbacher CM, Bhopal RS, Gray J, Metcalf JV, James OF. An exploratory population-based case-control study of primary biliary cirrhosis. Hepatology 2000; 31(5): 1055-060 CrossRef - 作者单位：Jiangyi Zhu (1)
Yongquan Shi (1)
Xinmin Zhou (1)
Zengshan Li (2)
Xiaofeng Huang (2)
Zheyi Han (1)
Jianhong Wang (1)
Ruian Wang (2)
Jie Ding (1)
Kaichun Wu (1)
Ying Han (1)
Daiming Fan (1)
1. State Key Laboratory of Cancer Biology, Institute of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi’an, 710032, China
2. Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi’an, 710032, China
文摘
The efficacy of ursodeoxycholic acid (UDCA) on long-term outcome of primary biliary cirrhosis (PBC) has been less documented in Chinese cohort. We aimed to assess the therapeutic effect of UDCA on Chinese patients with PBC. In the present study, 67 patients with PBC were treated with UDCA (13-5 mg·kg?·day?) and followed up for 2 years to evaluate the changes of symptoms, laboratory values and histological features. As the results indicated, fatigue and pruritus were obviously improved by UDCA, particularly in patients with mild or moderate symptoms. The alkaline phosphatase and γ-glutamyl transpetidase levels significantly declined at year 2 comparing to baseline values, with the most profound effects achieved in patients at stage 2. The levels of alanine aminotransferase and aspartate aminotransferase significantly decreased whereas serum bilirubin and immunoglobulin M levels exhibited no significant change. Histological feature was stable in patients at stages 1- but still progressed in patients at stages 3-. The biochemical response of patients at stage 2 was much better than that of patients at stages 3-. These data suggest that, when treated in earlier stage, patients in long-term administration of UDCA can gain favorable results not only on symptoms and biochemical responses but also on histology. It is also indicated that later histological stage, bad biochemical response and severe symptom may be indicators of poor prognosis for UDCA therapy.