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...
محفوظ في:
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| مؤلفون آخرون: | |
| التنسيق: | article |
| منشور في: |
2007
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| 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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| _version_ | 1864513463718510592 |
|---|---|
| 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_6e79f3eec344ce8e4d7c77323e0b7e1e |
| identifier_str_mv | 1060-0280 San Luis, V. A., & Btaiche, I. F. (2007). Ursodiol in patients with parenteral nutrition–associated cholestasis. Annals of Pharmacotherapy, 41(11), 1867-1872. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/4517 |
| publishDate | 2007 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
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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 |