E-Note for Adult
Stat | Lytes | Drugs | ID | Heart | Lungs | Kidneys | GI | Rheum | Heme-Onc | Endo | Neuro | Derm | Misc. | Resources | Home
|Primary Sclerosing Cholangitis
Combined Rx with Azathioprine, Prednisolone, and Ursodiol in Patients
with Primary Sclerosing
Measurements: Clinical and laboratory evaluation, liver biopsy, and endoscopic retrograde cholangiography (a >30% change in stenosis was considered significant).
Results: After a median observation period of 41 months (range, 3 to 81 months), liver enzyme levels declined significantly in all patients. Six of 10 patients with follow-up liver biopsies showed histologic improvement. Significant radiographic deterioration was seen in only 1 of 10 patients who had endoscopic retrograde cholangiography. In 7 patients previously treated with UDCA alone, liver enzyme levels declined significantly only after immunosuppressive therapy was added. Adverse drug reactions led to the withdrawal of study medications in 2 patients.
Conclusions: Combined immunosuppressive therapy may alter the progression
of primary sclerosing cholangitis. Our observations suggest a benefit from
adding immunosuppressive drugs to UDCA therapy. A randomized trial is warranted.