Triple therapy with ursodeoxycholic acid, budesonide and mycophenolate mofetil in patients with features of severe primary biliary cirrhosis not responding to ursodeoxycholic acid alone - 21/06/10
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Summary |
Background/Aims |
To assess the benefit of the UDCA–budesonide combination in association with mycophenolate mofetil (MMF) in patients with primary biliary cirrhosis (PBC) at high risk of developing cirrhosis or liver failure.
Methods |
Inclusion criteria for this three-year open study were: 1) suboptimal biochemical response to one-year UDCA therapy at 13–15mg/kg/d; 2) significant interface hepatitis without cirrhosis at liver biopsy. Treatment regimen included UDCA (13–15mg/kg/d), budesonide (6mg/d) and MMF (1.5g/d). All patients underwent a control biopsy at three years.
Results |
Fifteen patients fulfilled the inclusion criteria. Six patients (41%) normalized biochemistries and seven (47%) had a partial but significant biochemical response, as defined by a serum bilirubin less than 17μmol/L, alanine aminotransferase less than 70UI/L and alkaline phosphatase less than 250UI/L. Histological activity and fibrosis were markedly improved. Side effects were minimal or absent.
Conclusions |
Triple therapy with UDCA, budesonide and MMF may provide benefit in non-cirrhotic PBC patients with features of severe disease not responding to UDCA.
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Vol 34 - N° 4-5
P. 283-287 - avril 2010 Retour au numéro
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