High Doses of UDCA Not Beneficial for NASH Patients

Overall histology found the same in ursodeoxycholic acid and placebo recipients

WEDNESDAY, July 28 (HealthDay News) -- High doses of ursodeoxycholic acid (UDCA) do not appear to improve overall histology compared with placebo in patients with nonalcoholic steatohepatitis (NASH), according to a study published in the August issue of Hepatology.

Ulrich F.H. Leuschner, M.D., of Interdisziplinäres Facharztzentrum Sachsenhausen in Frankfurt, Germany, and colleagues used a modified Brunt score and also the nonalcoholic fatty liver disease activity score (NAS) to evaluate liver biopsies from before and after treatment. They had used the modified Brunt score to randomize 185 patients with histologically proven NASH; 147 were treated per protocol: with 23 to 28 mg/kg body weight daily doses of UDCA or placebo for 18 months, without dietary modification. Using the NAS, NASH was confirmed in 137 patients, 48 were determined to be borderline NASH, and one did not have NASH.

The researchers found no significant differences in overall histology using the two different scoring systems; the only significant improvement according to both scores was in lobular inflammation. This improvement was also noted in men, patients under 50, those who were slightly overweight, and patients who had hypertension and a higher histology score.

"High-dose UDCA failed to improve the overall histology in patients with NASH in comparison with placebo," the authors conclude.

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