Prognostic significance of serum tyrosine concentration in patients with primary biliary cholangitis under ursodeoxycholic acid therapy

2020 ◽  
Vol 50 (2) ◽  
pp. 214-223
Author(s):  
Nozomi Amano ◽  
Yuji Ikeda ◽  
Sho Hayashida ◽  
Sho Takahashi ◽  
Sho Sato ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Prognostic Significance ◽  
Primary Biliary Cholangitis ◽  
Acid Therapy ◽  
Tyrosine Concentration

scholarly journals In Silico Prediction and Pharmacokinetic Comparison of Ursodeoxycholic Acid and Obeticholic Acid in the Management of Primary Biliary Cholangitis

2021 ◽  
Vol 11 (2-S) ◽  
pp. 113-117
Author(s):  
Manali Sudhir Dhage ◽  
Nila Ganamurali ◽  
Dhivya Dhanasekaran ◽  
Sarvesh Sabarathinam
Keyword(s):  
Drug Interactions ◽  
Ursodeoxycholic Acid ◽  
In Silico ◽  
Software Tool ◽  
Pharmacokinetic Profile ◽  
Primary Biliary Cholangitis ◽  
Obeticholic Acid ◽  
Acid Therapy ◽  
Concurrent Use ◽  
Cyp3a4 Enzyme

Background: Primary Biliary Cholangitis (PBC) is a persistent liver disease. Ursodeoxycholic acid is used as a first-line treatment for the past two decades. However, concurrent use of Ursodeoxycholic acid reported with a severe adverse drug reaction. Obeticholic acid has been started utilizing as monotherapy and also with Ursodeoxycholic acid in a patient who is intolerant to Ursodeoxycholic acid therapy. We primarily aimed to compare the pharmacokinetic & toxicity profiles of Ursodeoxycholic acid and Obeticholic acid using in silico methods. Method: The pharmacokinetic profile of UDCA & OCA was observed from PKCSM server online database, OSIRIS® property Explorer, T.E.S.T. (Toxicity estimation software tool) & Molinspiration® is used to estimate the drug toxicity profiles. Result: This computer-aided response provides a great understanding and creates a gap between the theoretical and clinical evidence for UDCA & OCA's preference in PBC management. Conclusion: Co-administration of Obeticholic acid with Ursodeoxycholic acid will be an effective treatment for PBC in patients with UDCA intolerants. However, both medications are well-recognized substrates of the CYP3A4 enzyme and may lead to unintended drug interactions and side effects. Keywords: Primary Biliary Cholangitis, Obeticholic acid, Ursodeoxycholic acid, CYP3A4, Drug Interactions, Pharmacokinetics.

scholarly journals Ursodeoxycholic acid therapy and liver transplant-free survival in patients with primary biliary cholangitis

2019 ◽  
Vol 71 (2) ◽  
pp. 357-365 ◽  
Author(s):  
Maren H. Harms ◽  
Henk R. van Buuren ◽  
Christophe Corpechot ◽  
Douglas Thorburn ◽  
Harry L.A. Janssen ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Ursodeoxycholic Acid ◽  
Primary Biliary Cholangitis ◽  
Acid Therapy ◽  
Free Survival

scholarly journals Number needed to treat with ursodeoxycholic acid therapy to prevent liver transplantation or death in primary biliary cholangitis

Gut ◽  
2019 ◽  
Vol 69 (8) ◽  
pp. 1502-1509 ◽  
Author(s):  
Maren H Harms ◽  
Rozanne C de Veer ◽  
Willem J Lammers ◽  
Christophe Corpechot ◽  
Douglas Thorburn ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Ursodeoxycholic Acid ◽  
Primary Biliary Cholangitis ◽  
Number Needed To Treat ◽  
Proportional Hazard ◽  
Acid Therapy ◽  
Free Survival ◽  
Cox Proportional Hazard ◽  
Improve Patient

ObjectiveThe clinical benefit of ursodeoxycholic acid (UDCA) in primary biliary cholangitis (PBC) has never been reported in absolute measures. The aim of this study was to assess the number needed to treat (NNT) with UDCA to prevent liver transplantation (LT) or death among patients with PBC.MethodsThe NNT was calculated based on the untreated LT-free survival and HR of UDCA with respect to LT or death as derived from inverse probability of treatment weighting-adjusted Cox proportional hazard analyses within the Global PBC Study Group database.ResultsWe included 3902 patients with a median follow-up of 7.8 (4.1–12.1) years. The overall HR of UDCA was 0.46 (95% CI 0.40 to 0.52) and the 5-year LT-free survival without UDCA was 81% (95% CI 79 to 82). The NNT to prevent one LT or death within 5 years (NNT5y) was 11 (95% CI 9 to 13). Although the HR of UDCA was similar for patients with and without cirrhosis (0.33 vs 0.31), the NNT5y was 4 (95% CI 3 to 5) and 20 (95% CI 14 to 34), respectively. Among patients with low alkaline phosphatase (ALP) (≤2× the upper limit of normal (ULN)), intermediate ALP (2–4× ULN) and high ALP (>4× ULN), the NNT5y to prevent one LT or death was 26 (95% CI 15 to 70), 11 (95% CI 8 to 17) and 5 (95% CI 4 to 8), respectively.ConclusionThe absolute clinical efficacy of UDCA with respect to LT or death varied with baseline prognostic characteristics, but was high throughout. These findings strongly emphasise the incentive to promptly initiate UDCA treatment in all patients with PBC and may improve patient compliance.

scholarly journals Ursodeoxycholic Acid Therapy in Patients with Primary Biliary Cholangitis with Limited Liver Transplantation Availability

2017 ◽  
Vol 16 (3) ◽  
pp. 430-435 ◽  
Author(s):  
Yazmín Karel Melchor-Mendoza ◽  
Braulio Martínez-Benítez ◽  
Aline Mina-Hawat ◽  
Gustavo Rodríguez-Leal ◽  
Ximena Duque ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Ursodeoxycholic Acid ◽  
Primary Biliary Cholangitis ◽  
Acid Therapy

scholarly journals Primary Biliary Cholangitis and Ursodeoxycholic Acid: Therapy Progress and Challenges

Doctor Ru ◽  
2019 ◽  
Vol 158 (3) ◽  
pp. 33-39
Author(s):  
E.V. Vinnitskaya ◽  
◽  
K.G. Absandze ◽  
E.V. Arkhipova ◽  
A.N. Ivanov ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Primary Biliary Cholangitis ◽  
Acid Therapy

scholarly journals Prognostic Factors in Primary Biliary Cholangitis: A Retrospective Study of Joint Slovak and Croatian Cohort of 249 Patients

2021 ◽  
Vol 11 (6) ◽  
pp. 495
Author(s):  
Jakub Gazda ◽  
Sylvia Drazilova ◽  
Martin Janicko ◽  
Ivica Grgurevic ◽  
Tajana Filipec Kanizaj ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Treatment Response ◽  
Total Bilirubin ◽  
Primary Biliary Cholangitis ◽  
Regression Analyses ◽  
Laboratory Parameters ◽  
Liver Decompensation ◽  
Treatment Responses ◽  
The Relationship ◽  
Therapy Treatment

Objective: To identify pretreatment laboratory parameters associated with treatment response and to describe the relationship between treatment response and liver decompensation in patients with primary biliary cholangitis treated with ursodeoxycholic acid. Methods: We defined treatment response as both ALP ≤ 1.67 × ULN and total bilirubin ≤ 2 × ULN. Multiple logistic regression analyses were performed to adjust for confounding effects of sociodemographic variables. Results: Pretreatment total bilirubin ((TB); OR = 0.3388, 95%CI = 0.1671–0.6077), ALT (OR = 0.5306, 95%CI = 0.3830–0.7080), AST (OR = 0.4065, 95%CI = 0.2690–0.5834), ALP (OR = 0.3440, 95%CI = 0.2356–0.4723), total cholesterol ((TC); OR = 0.7730, 95%CI = 0.6242–0.9271), APRI (OR = 0.3375, 95%CI = 0.1833–0.5774), as well as pretreatment albumin (OR = 1.1612, 95%CI = 1.0706–1.2688) and ALT/ALP (OR = 2.4596, 95%CI = 1.2095–5.5472) were associated with treatment response after six months of treatment. Pretreatment TB (OR = 0.2777, 95%CI = 0.1288–0.5228), ALT (OR = 0.5968, 95%CI = 0.4354–0.7963), AST (OR = 0.4161, 95%CI = 0.2736–0.6076), ALP (OR = 0.4676, 95%CI = 0.3487–0.6048), APRI (OR = 0.2838, 95%CI = 0.1433–0.5141), as well as pretreatment albumin (OR = 1.2359, 95%CI = 1.1257–1.3714) and platelet count (OR = 1.0056, 95%CI = 1.0011–1.0103) were associated with treatment response after 12 months of treatment. Treatment response after 6 months of UDCA therapy is significantly associated with treatment response after 12 months of UDCA therapy (OR = 25.2976, 95% CI = 10.5881–68.4917). Treatment responses after 6 and 12 months of UDCA therapy decrease the risk of an episode of liver decompensation in PBC patients (OR = 12.1156, 95%CI = 3.7192–54.4826 and OR = 21.6000, 95%CI = 6.6319–97.3840, respectively). Conclusions: There are several pretreatment laboratory parameters associated with treatment response in patients with primary biliary cholangitis. Treatment response after six months is significantly associated with treatment response after 12 months of ursodeoxycholic acid (UDCA) therapy. Treatment responses after 6 and 12 months of UDCA decrease the risk of an episode of liver decompensation.

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