Ursodeoxycholic acid alone or with chenodeoxycholic acid for dissolution of cholesterol gallstones: a randomized multicentre trial

Petroni, Maria Letizia; Jazrawi, R. P.; Pazzi, P.; Lanzini, Alberto; Zuin, Massimo; Pigozzi, Marie Graciella; Fracchia, M.; Galatola, G.; Alvisi, Vittorio; Heaton, K W; Podda, Mauro; Northfield, T. C.

doi:10.1046/j.1365-2036.2001.00853.x

Cited by 38 publications

(27 citation statements)

References 20 publications

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“…Diarrhoea was the single most frequent adverse event during UDCA treatment in patients with gallstone disease, and has been reported at an incidence of 2–9% 50 ,. 63–65 In patients with primary biliary cirrhosis, diarrhoea was rarely observed and was only incidentally reported in three of five large‐scale trials 12 ,. 14 , 16 An increased incidence of diarrhoea by UDCA might be expected in the treatment of patients with primary sclerosing cholangitis and inflammatory bowel disease.…”

mentioning

confidence: 99%

Ursodeoxycholic acid — adverse effects and drug interactions

Hempfling¹,

Dilger

Beuers³

2003

Aliment Pharmacol Ther

103

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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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mentioning

confidence: 99%

Ursodeoxycholic acid — adverse effects and drug interactions

Hempfling¹,

Dilger

Beuers³

2003

Aliment Pharmacol Ther

103

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“…Combination of UDCA with chenodeoxycholic acid therapy enhances the biliary levels of UDCA [25]. Zuin et al [26] have obtained gallstone dissolution rate of 83% with UDCA plus chenodeoxycholic acid combination in 12 months, whereas Petroni et al [27] obtained a 30% dissolution rate with the same combination over 24 months. Moreover, Tazuma et al [28] have found 70% stone dissolution in multiple stones and 25% in solitary stones after 12 months treatment with UDCA.…”

Section: Discussionmentioning

confidence: 99%

Effect of Ursodeoxycholic Acid Alone and Ursodeoxycholic Acid Plus Domperidone on Radiolucent Gallstones and Gallbladder Contractility in Humans

Tuncer

Harman

Çolak

et al. 2012

Gastroenterology Research and Practice

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Background/Aims. The aim of this study was to compare the effects of ursodeoxycholic acid (UDCA) alone and UDCA plus domperidone on dissolution of solitary or multiple gallstones. Methods. Fifty-three patients with cholesterol gallstones were randomized into three treatment groups: group I (n = 22) was given UDCA (15 mg/kg/day) alone and group II (n = 18) was treated with domperidone (30 mg/day) in addition to UDCA. The control group (n = 13) was followed without a medical treatment. Gallbladder volumes and ejection fractions were measured sonographically in all patients before and after treatment. Results. After 12 months of treatment, stone dissolution was found in 9 (40.9%) of the patients in group I and 7 (38.8%) of the patients in group II. The difference was statistically significant compared to controls in both treatment groups (P < 0.05) but the two groups did not show a difference between each other (P > 0.05). All the patients that achieved dissolution had multiple gallstones except for one patient with a solitary stone in group I. Neither monotherapy of UDCA nor the combination with domperidone affected the ejection fraction of gallbladder. Conclusions. Combination with domperidone did not potentiate the efficacy of UDCA. It has been observed that both UDCA alone and UDCA plus domperidone treatment did not affect ejection fraction of gallbladder.

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“…(3) [71,72]. Finally, the efficacy of the bile acid UDCA in preventing gallstone related pain attacks and gallstone related complications (especially in patients with contraindications for operation or in those on the waiting list for laparoscopic cholecystectomy) should be investigated further , since two retrospective studies have demonstrated favourable outcomes for this strategy [73,74]. For this reason the results of a large double blind multi-center randomized controlled study of UDCA/Placebo treatment for symptomatic gallstone patients waiting for the laparoscopic operation on the waiting list in the Netherlands are anxiously awaited.…”

Section: Medication For Non-surgical Treatment Of Gallstone Diseasementioning

confidence: 98%

Drugs Affecting Biliary Lipid Secretion and Gallbladder Motility: Their Potential Role in Gallstone Treatment and Prevention

vanBerge-Henegouwen¹,

Venneman²,

Erpecum³

et al. 2005

curr drug targets immune endocr metabol disord

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Gallstone disease in the Western world has an estimated prevalence of 10-15% and more than 75% are cholesterol-enriched gallstones. Defective gallbladder motility has been identified as an important pathogenic factor for cholesterol gallstone disease. Various agents may enhance or impair postprandial gallbladder motility, and their effects on interdigestive gallbladder and intestinal motility should also be taken into account. Patients in high-risk situations for gallstone disease, and those chronically treated with drugs inhibiting gallbladder motility (e.g. somatostatin analogues) may benefit from improving gallbladder motility with prokinetic agents. Whether such a strategy can really prevent gallstone formation is still unknown, long-term studies are lacking so far. The efficacy of bile acid therapy with UDCA for gallstone dissolution or for prevention in high risk patients is limited and hampered by high recurrence rates. The efficacy of UDCA in prevention of colics or gallstone related complications in symptomatic patients with gallbladder stones with contraindications for operation or on the waiting list should be explored further, since several retrospective studies showed favourable outcomes with this strategy.

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Ursodeoxycholic acid alone or with chenodeoxycholic acid for dissolution of cholesterol gallstones: a randomized multicentre trial

Abstract: There is no substantial difference in the efficacy of combined ursodeoxycholic acid and chenodeoxycholic acid and that of ursodeoxycholic acid alone in terms of gallstone dissolution rate, complete gallstone dissolution, or relief of biliary pain.

Cited by 38 publications

References 20 publications

Ursodeoxycholic acid — adverse effects and drug interactions

Ursodeoxycholic acid — adverse effects and drug interactions

Effect of Ursodeoxycholic Acid Alone and Ursodeoxycholic Acid Plus Domperidone on Radiolucent Gallstones and Gallbladder Contractility in Humans

Drugs Affecting Biliary Lipid Secretion and Gallbladder Motility: Their Potential Role in Gallstone Treatment and Prevention

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