Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis

OBJECTIVE To review the role of ursodeoxycholic acid (ursodiol) in treating parenteral nutrition–associated cholestasis (PNAC). DATA SOURCES A MEDLINE (1950–May 2007) search was performed using the key terms parenteral nutrition, cholestasis, ursodeoxycholic acid, and ursodiol. STUDY SELECTION AND D...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Btaiche, Imad F. (author)
مؤلفون آخرون: San Luis, Valerie A. (author)
التنسيق: article
منشور في: 2007
الوصول للمادة أونلاين:http://hdl.handle.net/10725/4517
http://dx.doi.org/10.1345/aph.1K229
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://aop.sagepub.com/content/41/11/1867.short
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author Btaiche, Imad F.
author2 San Luis, Valerie A.
author2_role author
author_facet Btaiche, Imad F.
San Luis, Valerie A.
author_role author
dc.creator.none.fl_str_mv Btaiche, Imad F.
San Luis, Valerie A.
dc.date.none.fl_str_mv 2007
2016-10-06T09:55:32Z
2016-10-06T09:55:32Z
2016-10-06
dc.identifier.none.fl_str_mv 1060-0280
http://hdl.handle.net/10725/4517
http://dx.doi.org/10.1345/aph.1K229
San Luis, V. A., & Btaiche, I. F. (2007). Ursodiol in patients with parenteral nutrition–associated cholestasis. Annals of Pharmacotherapy, 41(11), 1867-1872.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://aop.sagepub.com/content/41/11/1867.short
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Annals of Pharmacotherapy
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description OBJECTIVE To review the role of ursodeoxycholic acid (ursodiol) in treating parenteral nutrition–associated cholestasis (PNAC). DATA SOURCES A MEDLINE (1950–May 2007) search was performed using the key terms parenteral nutrition, cholestasis, ursodeoxycholic acid, and ursodiol. STUDY SELECTION AND DATA EXTRACTION All English-language articles that evaluated the safety and efficacy of ursodiol for PNAC were included in this review. DATA SYNTHESIS The benefits of exogenous ursodiol administration in the treatment of cholestasis can be explained by its alteration of effects on bile composition and flow and provision of cytoprotective, membrane stabilizing, and immunomodulatory effects. Two animal studies, 2 case reports, and 6 human studies (2 prospective and 3 retrospective pediatric studies, 1 adult prospective study) evaluated the efficacy of ursodiol in patients with PNAC. Ursodiol 10–30 mg/kg/day in children and 10–15 mg/kg/day in adults administered in 2–3 doses improved the biochemical and clinical signs and symptoms of PNAC. However, short-term improvement in biochemical parameters may not necessarily predict the outcome of PNAC patients. At recommended doses, ursodiol may not be effective in patients with short bowel syndrome or in those with resected terminal ileum because of reduced ursodiol absorption. Studies supporting the efficacy of ursodiol in treatment of PNAC are limited by small sample size, absence of randomization and controls, short duration, and lack of accountancy to confounding variables. Large, prospective, randomized, placebo-controlled, long-term follow-up studies evaluating the efficacy and optimal dosing and duration of ursodiol therapy for PNAC are not yet available. CONCLUSIONS Ursodiol may improve the biochemical signs and clinical symptoms of PNAC. However, optimal dosing, timing, duration of therapy, and long-term effects on PNAC outcome and prognosis require further studies.
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San Luis, V. A., & Btaiche, I. F. (2007). Ursodiol in patients with parenteral nutrition–associated cholestasis. Annals of Pharmacotherapy, 41(11), 1867-1872.
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spelling Ursodiol in Patients with Parenteral Nutrition–Associated CholestasisBtaiche, Imad F.San Luis, Valerie A.OBJECTIVE To review the role of ursodeoxycholic acid (ursodiol) in treating parenteral nutrition–associated cholestasis (PNAC). DATA SOURCES A MEDLINE (1950–May 2007) search was performed using the key terms parenteral nutrition, cholestasis, ursodeoxycholic acid, and ursodiol. STUDY SELECTION AND DATA EXTRACTION All English-language articles that evaluated the safety and efficacy of ursodiol for PNAC were included in this review. DATA SYNTHESIS The benefits of exogenous ursodiol administration in the treatment of cholestasis can be explained by its alteration of effects on bile composition and flow and provision of cytoprotective, membrane stabilizing, and immunomodulatory effects. Two animal studies, 2 case reports, and 6 human studies (2 prospective and 3 retrospective pediatric studies, 1 adult prospective study) evaluated the efficacy of ursodiol in patients with PNAC. Ursodiol 10–30 mg/kg/day in children and 10–15 mg/kg/day in adults administered in 2–3 doses improved the biochemical and clinical signs and symptoms of PNAC. However, short-term improvement in biochemical parameters may not necessarily predict the outcome of PNAC patients. At recommended doses, ursodiol may not be effective in patients with short bowel syndrome or in those with resected terminal ileum because of reduced ursodiol absorption. Studies supporting the efficacy of ursodiol in treatment of PNAC are limited by small sample size, absence of randomization and controls, short duration, and lack of accountancy to confounding variables. Large, prospective, randomized, placebo-controlled, long-term follow-up studies evaluating the efficacy and optimal dosing and duration of ursodiol therapy for PNAC are not yet available. CONCLUSIONS Ursodiol may improve the biochemical signs and clinical symptoms of PNAC. However, optimal dosing, timing, duration of therapy, and long-term effects on PNAC outcome and prognosis require further studies.PublishedN/A2016-10-06T09:55:32Z2016-10-06T09:55:32Z20072016-10-06Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1060-0280http://hdl.handle.net/10725/4517http://dx.doi.org/10.1345/aph.1K229San Luis, V. A., & Btaiche, I. F. (2007). Ursodiol in patients with parenteral nutrition–associated cholestasis. Annals of Pharmacotherapy, 41(11), 1867-1872.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttp://aop.sagepub.com/content/41/11/1867.shortenAnnals of Pharmacotherapyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/45172021-03-19T10:03:23Z
spellingShingle Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis
Btaiche, Imad F.
status_str publishedVersion
title Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis
title_full Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis
title_fullStr Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis
title_full_unstemmed Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis
title_short Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis
title_sort Ursodiol in Patients with Parenteral Nutrition–Associated Cholestasis
url http://hdl.handle.net/10725/4517
http://dx.doi.org/10.1345/aph.1K229
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://aop.sagepub.com/content/41/11/1867.short