Clinical efficacy of ursodesoxycholic acid for the treatment of primary biliary cirrhosis: a Meta-analysis

doi:10.3877/cma.j.issn.2095-3232.2017.04.019

Abstract

Abstract:

Objective

To investigate the clinical efficacy and safety of ursodesoxycholic acid (UCDA) for the treatment of primary biliary cirrhosis (PBC).

Methods

Randomized control trials literatures related to the treatment of PBC with UDCA up to October 2016 were searched by computer from PubMed, Wanfang database and CNKI. The keywords were respectively ursodeoxycholic acid, ursodiol, primary biliary cirrhosis and random clinical trials both in Chinese and English. Clinical data including liver function indexes, clinical symptoms, incidence of adverse reactions and mortality were extracted and subjected to Meta-analysis. Heterogenous studies were analyzed using random effect model, and homogenous studies were analyzed using fixed effect model.

Results

A total of 863 patients in 8 literatures were included in this study. Meta-analysis indicated that UCDA could significantly improve the levels of ALT, AST, ALP, GGT and TB (SMD=-0.73, -0.87, -1.22, -1.58, -0.32; P<0.05). UCDA could not significantly improve the symptoms of pruritus and fatigue, and did not significantly increase the incidence of adverse reactions (OR=1.03, P>0.05) and decrease the liver transplantation rate, mortality and liver disease related-mortality (OR=0.50, 0.79, 0.75; P>0.05).

Conclusions

UCDA can significantly improve the liver function of the PBC patients. But it fails to prevent the progression of PBC to end-stage liver disease, prolong the survival of the patients or improve the clinical symptoms.

Key words: Ursodeoxycholic acid, Liver cirrhosis, biliary, Meta-analysis

Jingxian Gu, Kai Qu, Chang Liu. Clinical efficacy of ursodesoxycholic acid for the treatment of primary biliary cirrhosis: a Meta-analysis[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2017, 06(04): 320-323.

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References 20

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作者	发表时间（年）	病例数（例，T/C）	平均年龄（岁，T/C）	观察时间（月）	组织学分期（例，Ⅰ+Ⅱ，Ⅲ+Ⅳ，T/C）	基线资料	盲法	ITT分析	NOS质量评分
Heathcote等^[7]	1994	108/107	57.3/55.4	24	50,57/47,60	可比	双盲	采用	8
Poupon等^[8]	1994	72/73	55/57	24	36,36/42,31	可比	双盲	采用	6
Vuoristo等^[9]	1995	30/31	52/57	24	-	可比	双盲	采用	7
Pares等^[10]	2000	99/93	54.7/53.5	41	65,27/61,25	可比	双盲	采用	7
戴善梅等^[11]	2006	16/14	53	04	-	可比	双盲	采用	5
冀霞等^[12]	2010	27/27	46.8	03	-	可比	单盲	采用	5
袁淑芳等^[13]	2012	23/23	37.2/37.2	03	-	可比	单盲	采用	5
刘平等^[14]	2013	60/60	53	0-	-	可比	单盲	采用	4

作者	发表时间（年）	病例数（例，T/C）	平均年龄（岁，T/C）	观察时间（月）	组织学分期（例，Ⅰ+Ⅱ，Ⅲ+Ⅳ，T/C）	基线资料	盲法	ITT分析	NOS质量评分
Heathcote等^[7]	1994	108/107	57.3/55.4	24	50,57/47,60	可比	双盲	采用	8
Poupon等^[8]	1994	72/73	55/57	24	36,36/42,31	可比	双盲	采用	6
Vuoristo等^[9]	1995	30/31	52/57	24	-	可比	双盲	采用	7
Pares等^[10]	2000	99/93	54.7/53.5	41	65,27/61,25	可比	双盲	采用	7
戴善梅等^[11]	2006	16/14	53	04	-	可比	双盲	采用	5
冀霞等^[12]	2010	27/27	46.8	03	-	可比	单盲	采用	5
袁淑芳等^[13]	2012	23/23	37.2/37.2	03	-	可比	单盲	采用	5
刘平等^[14]	2013	60/60	53	0-	-	可比	单盲	采用	4

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