The Systematic Review On Ursodeoxycholic Acid For Primary Biliary Cirrhosis

Objective: to evaluate the long-term (more than one year) efficacy and safety ofUDCA for PBC.Methods: In randomized controlled trials of taking ursodeoxycholic acid andplacebo for the treatment of primary biliary cirrhosis all over the world, according to theprinciple of evidence-based medicine, we searched data fromCochrane,Pubmed,EMBase,CNKI,CBM,VIP and WANGFANG,And we used thesystem-evaluation software provided by the Cochrane Library to evaluate the long-term(more than one year) efficacy and safety of UDCA for PBC. We searched published orunpublished articles of magazines or journals manually and searched all the articles byinternet. The search lasted to June,2012. The quality of the documents was assessed bytwo reviewers separately, and checked crossly. We solved objections by discussing orconsulted the third witness when there is discrepancy.Meta-analysis was performed according to the data and its results were assessed bysensitive analysis and bias analysis.Result: We included six randomized controlled trials containing818participants.The treatment group contained412participants and the control group contained406participants.Meta-analysis showed:1)There was no significantly difference indeath[PetoOR=0.90,95%CI(0.50,1.63),P=0.72],liver transplantation[PetoOR=0.84,95%CI(0.49,1.44),P=0.52],death and/or liver transplantation[PetoOR=0.86,95%CI(0.56,1.30),P=0.46];2)symptoms were not significantly different in the fatigue[PetoOR=0.80,95%CI(0.53,1.20),P=0.28],pruritus [PetoOR=0.99,95%CI(0.67,1.46),P=0.96];3)There was much significantly difference in theSTB[WMD=-11.29μmol/l,95%CI (-19.90,-2.28) μmol/l],AST[WMD=-29.56U/L,95%CI(-45.93,-13.19)U/L],ALT[WMD=-34.21U/L,95%CI(-43.02,-25.39)U/L],GGT[WMD=-253.74U/L,95%CI(-261.81,-245.66)U/L],IgM[WMD=-1.33g/l,95%CI(-1.43,-1.22)g/l];4)adverse event was no different [PetoOR=1.04,95%CI(0.52,2.11),P=0.90].Conclusions: The analysis shows important improvement of liver biochemistry, butno improvement of clinical symptoms by taking UDCA for a long term.UDCA is still thepreferred drug to primary biliary cirrhosis patients because its high safety and lessadverse reactions.