Ursodeoxycholic acid for the treatment of intrahepatic cholestasis of pregnancy

Laifer, Steven A.; Stiller, Robert J.; Siddiqui, Danish

doi:10.1016/s0029-7844(99)90104-7

Cited by 6 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This effect seems to be independent of the effect on BA excretion 112 . The studies on UDCA vs. placebo in intrahepatic cholestasis of pregnancy are shown in Table 4 113–117 . In all studies, patients on UDCA treatment experienced subjective improvement and, not uncommonly, complete resolution of pruritus (significant reduction in four of the five studies), as assessed by five‐point scales.…”

Section: Pruritus In Intrahepatic Cholestasis Of Pregnancymentioning

confidence: 97%

Pruritus in cholestatic and other liver diseases

Mela

Mancuso

Burroughs

2003

Aliment Pharmacol Ther

116

View full text Add to dashboard Cite

Summary Pruritus is often the most troublesome symptom in patients with chronic liver disease, particularly when cholestasis is a prominent feature. The exact pathogenesis is unknown, but empirical treatment, such as cholestyramine, based on a liver‐based origin of pruritus, has been used for many years. Recently, evidence for a central mechanism for pruritus has been obtained and opioid antagonists have been tried clinically with some benefit, but their use is not widespread. In addition, the pruritus associated with intrahepatic cholestasis of pregnancy can now be alleviated in many cases by ursodeoxycholic acid. As it also improves foetal outcome, this should become first‐line therapy. We review the pathogenesis and therapy of pruritus, highlighting practical aspects to help with patients with seemingly intractable pruritus.

show abstract

Section: Pruritus In Intrahepatic Cholestasis Of Pregnancymentioning

confidence: 97%

Pruritus in cholestatic and other liver diseases

Mela

Mancuso

Burroughs

2003

Aliment Pharmacol Ther

116

View full text Add to dashboard Cite

show abstract

“…To minimize risks to the fetus, practitioners recommend inducing labor at 36 weeks of gestation in severe cases and at 38 weeks in mild cases of ICP. Daily ursodeoxycholic acid (15 mg/kg), which promotes excretion of bile acids and other hepatotoxic substances, may help to reduce the risk of fetal morbidities while alleviating pruritus and other maternal symptoms 26,59 . Emollients, topical antipruritics, rest, and a low‐fat diet may also help ease symptoms in some patients 26,51,60 .…”

Section: Dermatoses Of Pregnancymentioning

confidence: 99%

Physiologic changes and dermatoses of pregnancy

Geraghty

Pomeranz

2011

Int J Dermatology

View full text Add to dashboard Cite

Like all organ systems, the skin undergoes significant changes during pregnancy. The majority of physiologic skin conditions related to gestation resolve after childbirth. However, they may cause significant concern or cosmetic distress or be mistaken for one of the specific dermatoses of pregnancy. Dermatoses unique to pregnancy are rare but important to recognize because they may be intensely pruritic or painful to the mother, and they may pose significant risks to the patient, her fetus, or both. Clinicians familiar with the cutaneous manifestations of pregnancy can most effectively treat and counsel patients, guide expectations, and avoid unnecessary diagnostic tests and therapies. This review summarizes physiologic skin changes in the gravid patient and the specific dermatoses of pregnancy.

show abstract

“…Recent studies of ICP in the U.S. confirm that it is more common in Latinas (incidences of 1.9% and 5.6% in predominantly Latina California obstetric populations), while it is relatively rare in obstetric populations that have a low proportion of Latinas (incidences of 0.32% and 0.25%) [ 19 – 22 ]. Two single-center studies of ethnically heterogeneous obstetric populations confirm that Latinas are at increased risk of ICP; in our study of such a population in San Francisco, Latinas had a substantially increased probability of having ICP (RR 4.96; 95% CI 2.59–9.51) compared to women of other ancestries [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Intrahepatic Cholestasis of Pregnancy (ICP) in U.S. Latinas and Chileans: Clinical features, Ancestry Analysis, and Admixture Mapping

Bull

Shah

et al. 2015

PLoS ONE

View full text Add to dashboard Cite

In the Americas, women with Indigenous American ancestry are at increased risk of intrahepatic cholestasis of pregnancy (ICP), relative to women of other ethnicities. We hypothesized that ancestry-related genetic factors contribute to this increased risk. We collected clinical and laboratory data, and performed biochemical assays on samples from U.S. Latinas and Chilean women, with and without ICP. The study sample included 198 women with ICP (90 from California, U.S., and 108 from Chile) and 174 pregnant control women (69 from California, U.S., and 105 from Chile). SNP genotyping was performed using Affymetrix arrays. We compared overall genetic ancestry between cases and controls, and used a genome-wide admixture mapping approach to screen for ICP susceptibility loci. We identified commonalities and differences in features of ICP between the 2 countries and determined that cases had a greater proportion of Indigenous American ancestry than did controls (p = 0.034). We performed admixture mapping, taking country of origin into account, and identified one locus for which Native American ancestry was associated with increased risk of ICP at a genome-wide level of significance (P = 3.1 x 10-5, Pcorrected = 0.035). This locus has an odds ratio of 4.48 (95% CI: 2.21-9.06) for 2 versus zero Indigenous American chromosomes. This locus lies on chromosome 2, with a 10 Mb 95% confidence interval which does not contain any previously identified hereditary ‘cholestasis genes.’ Our results indicate that genetic factors contribute to the risk of developing ICP in the Americas, and support the utility of clinical and genetic studies of ethnically mixed populations for increasing our understanding of ICP.

show abstract

Ursodeoxycholic acid for the treatment of intrahepatic cholestasis of pregnancy

Cited by 6 publications

References 0 publications

Pruritus in cholestatic and other liver diseases

Pruritus in cholestatic and other liver diseases

Physiologic changes and dermatoses of pregnancy

Intrahepatic Cholestasis of Pregnancy (ICP) in U.S. Latinas and Chileans: Clinical features, Ancestry Analysis, and Admixture Mapping

Contact Info

Product

Resources

About