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Titolo:
Treatment of primary biliary cirrhosis
Autore:
Poupon, R; Poupon, RE;
Indirizzi:
Hop St Antoine, Serv Hepatogastroenterol, F-75571 Paris 12, France Hop St Antoine Paris France 12 togastroenterol, F-75571 Paris 12, France INSERM, U370, Paris, France INSERM Paris FranceINSERM, U370, Paris, France
Titolo Testata:
BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY
fascicolo: 4, volume: 14, anno: 2000,
pagine: 615 - 628
SICI:
1521-6918(200008)14:4<615:TOPBC>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
URSODEOXYCHOLIC-ACID THERAPY; RANDOMIZED CONTROLLED TRIALS; PLACEBO-CONTROLLED TRIAL; LIVER-TRANSPLANTATION; D-PENICILLAMINE; DOUBLE-BLIND; HISTOLOGICAL EVIDENCE; DISEASE RECURRENCE; RELIEVE PRURITUS; TREATED PATIENTS;
Keywords:
cholestasis; primary biliary cirrhosis; fibrosis; immunosuppression; ursodeoxycholic acid; liver transplantation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
73
Recensione:
Indirizzi per estratti:
Indirizzo: Poupon, R Hop St Antoine, Serv Hepatogastroenterol, 184 Rue Faubourg St Antoine, F-75571 Paris 12, France Hop St Antoine 184 Rue Faubourg St Antoine Paris France 12 ance
Citazione:
R. Poupon e R.E. Poupon, "Treatment of primary biliary cirrhosis", BEST PR RES, 14(4), 2000, pp. 615-628

Abstract

Although primary biliary cirrhosis (PBC) is generally a progressive disease, the rate of progression varies greatly from one patient to another. The terminal phase is characterized by hyperbilirubinaemia (> 100 mu mol/l), a major decrease in the number of intrahepatic bile ducts, and extensive fibrosis or cirrhosis. It is now well established that orthotopic liver transplantation is the treatment of choice for patients entering the terminal phase of the disease. A variety of therapeutic agents have been proposed for treatment of patients with PBC. However, most have been found ineffective or coo toxic to be widely used. In contrast, there is accumulating evidence from large therapeutic trials that long-term administration of ursodeoxycholic acid (UDCA) is safe and prolongs survival free of liver transplantation. Treatment with UDCA slows the histological progression and delays the onset of cirrhosis. In patients who have a sub-optimal response to UDCA therapy alone, the combination of colchicine or methotrexate with UDCA has minimal or no additional benefit, whereas that with corticosteroids is more promising but not yetdemonstrated. Among causes of non-response to UDCA therapy, the most common is the PBC-autoimmune hepatitis overlap syndrome. The benefit from the combination of corticosteroids and UDCA in this setting is obvious. Further studies are needed to define the patients who are most likely to respond to UDCA therapy and to assess the benefit of combined medical treatments.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 14:52:53