Re: urso (continued)

[Guest guest]

Hi Stuart;

I think this may be the Dutch study referred to by Dr. Chapman in my

previous message:

J Hepatol. 1996 Dec;25(6):887-94.

Single or multiple dose ursodeoxycholic acid for cholestatic liver

disease: biliary enrichment and biochemical response.

van de Meeberg PC, Wolfhagen FH, Van Berge-Henegouwen GP, Salemans

JM, Tangerman A, van Buuren HR, van Hattum J, van Erpecum KJ

University Hospital Utrecht, Department of Gastroenterology, The

Netherlands.

BACKGROUND: Ursodeoxycholic acid (UDCA) improves liver biochemistry

in primary biliary cirrhosis (PBC) and primary sclerosing

cholangitis (PSC). Since UDCA acts partly by reducing the intestinal

absorption of hydrophobic endogenous bile salts and is poorly

absorbed from the intestine, a multiple dose regimen has been

advocated. Single dose treatment, on the other hand, may improve

compliance. AIM: The effects of a single or multiple dose regimen on

liver enzymes and serum and biliary bile salts composition were

evaluated. METHODS: Twenty-seven patients (19 PSC, 8 PBC), most with

early stage disease, received UDCA (10 mg kg-1 day-1) in a single

dose at bed time (n = 13) or in three divided gifts with meals (n =

14) over 3 months. Five patients had both treatment regimens in

random order with a 1-month wash-out period in between. RESULTS:

Liver biochemistry equally improved in both groups. Biliary

enrichment (% UDCA of total bile salts, mean +/- SEM) was 40.1 +/-

2.4 in the single dose group vs 40.8 +/- 2.8 in the multiple dose

group (p = NS) and was positively correlated with biochemical

improvement (AP: r = 0.47, p = 0.02; GGT: r = 0.58, p = 0.002; ASAT:

r = 0.67, p = 0.002; ALAT: r = 0.52, p = 0.01). Biochemical

improvement was not correlated with the concentration or %UDCA in

serum. Patients participating in the cross-over design had

comparable biochemical response and biliary %UDCA during both

regimens. CONCLUSION: Single and multiple dose UDCA have similar

effects on liver biochemistry and biliary enrichment in cholestatic

liver disease. Biochemical improvement appears to be related to

biliary (but not serum) enrichment with UDCA. PMID: 9007717.

Best regards,

Dave R.