Ursodeoxycholic acid in treatment of cholestatic liver diseases especially primary biliary cirrhosis and primary sclerosing cholangitis
Abstract
Clear and crucial progress in understanding of principles of cholestasis and molecular/molecular-genetic basis of cholestatic liver diseases including the identification of key transporters of individual bile components, seen in the past decade, did not result in adequate improvement in management of these disorders so far, especially from the causal point of view. Currently, we can treat primary biliary cirrhosis effectively using ursodeoxycholic acid (UDCA), which was shown to slow the progression of the disease, improve the survival of patients and postpone the development of complications.
The use of UDCA in pregnant patients with intrahepatic cholestasis seems to have similar effectiveness. So far, no effective pharmacotherapy is available for patients with primary sclerosing cholangitis, the use of UDCA in this indication remaining controversial; the management of choice consists of endoscopic treatment of dominant stenoses and of early liver transplantation.