Combination Therapy Of Ursodeoxycholic Acid And Immunosuppressant For AIH-PBC Overlap Syndrome:A Meta-Analysis

ObjectiveTo investigate the efficacy of combination therapy of ursodeoxycholic acid(UDCA)and immunosuppressant(IS)for autoimmune hepatitis-primary biliary cholangitis overlap syndrome(AIH-PBC OS).MethodsThe study group was treated by UDCA combined with IS,and monotherapy with UDCA in the control group.Literatures search was performed according to Cochrane strategy.The inclusion and exclusion criteria were defined by PICO.The researchers completed literature's data screening and quality evaluation respectively.Meta-analysis was performed with RevMan 5.3 software.ResultsA total of 252 patients in 8 literatures were included this study.ALT response improved by the combination therapy was more effective than monotherapy [OR=6.25,95%CI(2.25,18.82),P<0.0006].Further ALP response showed analogue[OR=2.03,95%CI(1.09,3.77),P=0.03],and IgG response analogue [OR=7.41,95%CI(3.04,18.06),P<0.0001].And then there was significant negative correlation with the risk of liver's fibrosis progress in the combination therapy[OR=0.25,95%CI(0.07,0.86),P=0.03],liver-related worsening events were analogue[OR=0.11,95%CI(0.03,0.42),P=0.001],and so were liver transplantation or mortality[OR=0.15,95%CI(0.03,0.78),P=0.02].ConclusionsThe combination therapy of UDCA and IS on AIH-PBC OS can improve the serum ALT,ALP and IgG response,further lower the risks of fibrotic progress of liver,liver-related worsening events,and so is liver transplantation or mortality.