Primary sclerosing cholangitis medical therapy: Difference between revisions

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==Medical Therapy==
==Medical Therapy==
* [[Liver transplantation]] is the gold standard for treatment of primary sclerosing cholangitis and there is no effective medical treatment.
* [[Liver transplantation]] is the gold standard for treatment of primary sclerosing cholangitis and there is no effective medical treatment.
* [[Ursodeoxycholic acid]] in the dose of 10-15 mg/kg/day has been studied as a treatment for the disease.  
* [[Ursodeoxycholic acid]] (UDCA) in the dose of 10-15 mg/kg/day has been studied as a treatment for the disease.  
** However, there is no proof for the use of [[Ursodeoxycholic acid]] in patients with primary sclerosing cholangitis.
** However, there is no proof for the use of [[Ursodeoxycholic acid]] in patients with primary sclerosing cholangitis.
*** The ''American College of Gastroenterology,'' 2015 guidelines does not support the use of [[Ursodeoxycholic acid]] in patients with primary sclerosing cholangitis.<ref name="pmid20101749">{{cite journal |vauthors=Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ |title=Diagnosis and management of primary sclerosing cholangitis |journal=Hepatology |volume=51 |issue=2 |pages=660–78 |year=2010 |pmid=20101749 |doi=10.1002/hep.23294 |url=}}</ref><ref name="pmid19501929">{{cite journal |vauthors= |title=EASL Clinical Practice Guidelines: management of cholestatic liver diseases |journal=J. Hepatol. |volume=51 |issue=2 |pages=237–67 |year=2009 |pmid=19501929 |doi=10.1016/j.jhep.2009.04.009 |url=}}</ref><ref name="pmid25869391">{{cite journal |vauthors=Lindor KD, Kowdley KV, Harrison ME |title=ACG Clinical Guideline: Primary Sclerosing Cholangitis |journal=Am. J. Gastroenterol. |volume=110 |issue=5 |pages=646–59; quiz 660 |year=2015 |pmid=25869391 |doi=10.1038/ajg.2015.112 |url=}}</ref>  
*** The ''American College of Gastroenterology,'' 2015 guidelines does not support the use of [[ursodeoxycholic acid]] in patients with primary sclerosing cholangitis.<ref name="pmid20101749">{{cite journal |vauthors=Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ |title=Diagnosis and management of primary sclerosing cholangitis |journal=Hepatology |volume=51 |issue=2 |pages=660–78 |year=2010 |pmid=20101749 |doi=10.1002/hep.23294 |url=}}</ref><ref name="pmid19501929">{{cite journal |vauthors= |title=EASL Clinical Practice Guidelines: management of cholestatic liver diseases |journal=J. Hepatol. |volume=51 |issue=2 |pages=237–67 |year=2009 |pmid=19501929 |doi=10.1016/j.jhep.2009.04.009 |url=}}</ref><ref name="pmid25869391">{{cite journal |vauthors=Lindor KD, Kowdley KV, Harrison ME |title=ACG Clinical Guideline: Primary Sclerosing Cholangitis |journal=Am. J. Gastroenterol. |volume=110 |issue=5 |pages=646–59; quiz 660 |year=2015 |pmid=25869391 |doi=10.1038/ajg.2015.112 |url=}}</ref>  
*** The ''American Association for the Study of Liver Diseases,'' 2010 guidelines recommends ''against'' the use of UDCA in the treatment of primary sclerosing cholangitis 
*** The ''American Association for the Study of Liver Diseases,'' 2010 guidelines recommends ''against'' the use of [[ursodeoxycholic acid]] in the treatment of primary sclerosing cholangitis.
* Associated medical conditions and manifestations of [[end-stage liver disease]] ([[ESLD]]) can be targeted by medical therapy and/or surgery.
* Associated medical conditions and manifestations of [[end-stage liver disease]] ([[ESLD]]) can be targeted by medical therapy and/or surgery.



Revision as of 20:54, 20 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Overview

Liver transplantation is the gold standard for treatment of primary sclerosing cholangitis and there is no effective medical treatment. Ursodeoxycholic acid has been studied as a treatment for the disease. However, there is no proof for its benefit and the American College of Gastroenterology does not support its use in patients with primary sclerosing cholangitis.

Medical Therapy

  • Liver transplantation is the gold standard for treatment of primary sclerosing cholangitis and there is no effective medical treatment.
  • Ursodeoxycholic acid (UDCA) in the dose of 10-15 mg/kg/day has been studied as a treatment for the disease.
    • However, there is no proof for the use of Ursodeoxycholic acid in patients with primary sclerosing cholangitis.
      • The American College of Gastroenterology, 2015 guidelines does not support the use of ursodeoxycholic acid in patients with primary sclerosing cholangitis.[1][2][3]
      • The American Association for the Study of Liver Diseases, 2010 guidelines recommends against the use of ursodeoxycholic acid in the treatment of primary sclerosing cholangitis.
  • Associated medical conditions and manifestations of end-stage liver disease (ESLD) can be targeted by medical therapy and/or surgery.

References

  1. Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ (2010). "Diagnosis and management of primary sclerosing cholangitis". Hepatology. 51 (2): 660–78. doi:10.1002/hep.23294. PMID 20101749.
  2. "EASL Clinical Practice Guidelines: management of cholestatic liver diseases". J. Hepatol. 51 (2): 237–67. 2009. doi:10.1016/j.jhep.2009.04.009. PMID 19501929.
  3. Lindor KD, Kowdley KV, Harrison ME (2015). "ACG Clinical Guideline: Primary Sclerosing Cholangitis". Am. J. Gastroenterol. 110 (5): 646–59, quiz 660. doi:10.1038/ajg.2015.112. PMID 25869391.


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