التفاصيل البيبلوغرافية
| العنوان: |
Combined therapy with azathioprine, prednisolone, and ursodiol in patients with primary sclerosing cholangitis. A case series. |
| المؤلفون: |
Schramm, Christoph, Schirmacher, Peter, Schramm, C, Schirmacher, P, Helmreich-Becker, I, Gerken, G, zum Büschenfelde, K H, Lohse, A W |
| المصدر: |
Annals of Internal Medicine; 12/21/99, Vol. 131 Issue 12, p943-946, 4p, 1 Chart, 6 Graphs |
| مصطلحات موضوعية: |
LIVER disease treatment, IMMUNOSUPPRESSIVE agents |
| مستخلص: |
Background: No established medical therapy alters the progressive course of primary sclerosing cholangitis.Objective: To explore the potential usefulness of combined therapy with azathioprine, steroids and ursodeoxycholic acid (UDCA) in primary sclerosing cholangitis.Design: Case series.Setting: University hospital in Mainz, Germany.Patients: 15 patients with primary sclerosing cholangitis.Intervention: Azathioprine (1 to 1.5 mg/kg of body weight per day), prednisolone (1 mg/kg per day initially, tapering to 5 to 10 mg per day) and UDCA (500 to 750 mg per day).Measurements: Clinical and laboratory evaluation, liver biopsy, and endoscopic retrograde cholangiography (a >30% change in stenosis was considered significant).Results: After a median observation period of 41 months (range, 3 to 81 months), liver enzyme levels declined significantly in all patients. Six of 10 patients with follow-up liver biopsies showed histologic improvement. Significant radiographic deterioration was seen in only 1 of 10 patients who had endoscopic retrograde cholangiography. In 7 patients previously treated with UDCA alone, liver enzyme levels declined significantly only after immunosuppressive therapy was added. Adverse drug reactions led to the withdrawal of study medications in 2 patients.Conclusions: Combined immunosuppressive therapy may alter the progression of primary sclerosing cholangitis. Our observations suggest a benefit from adding immunosuppressive drugs to UDCA therapy. A randomized trial is warranted. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
