Ursodeoxiholic acid in the treatment of alcoholic liver disease

Abstract

Introduction: Alcoholic steatosis (AS) and alcoholic steatohepatitits (ASH) is associated with inflammation, liver cell necrosis, impaired liver function, and progression to alcoholic cirrhosis (AC). Ursodeoxyholic acid (UDCA) has been reported to be useful for patients with various liver diseases. Aim of study: In the present study we investigated the effects of long-term treatment UDCA in alcoholic liver disease (ALD). Material and methods: 53 patients with clinical, biochemical and histological proven alcoholic liver disease were treated with UDCA 15±2 mg/kg/day for a period of 36 months. The patients were selected in 3 groups: 21 with AS, 17 with AH and 15 with AC. Clinical symptoms (weakness, anorexia, weight loss, nausea, vomiting, right upper quadrant abdominal pain, jaundice, pruritus, fatigue), biochemical parameters (y-glutamyl trans-peptidase, aminotransferases, alkaline phosphates and serum bilirubin level) and histological parameters were followed for a period of 3 years. Results: UDCA improved clinical symptoms in 51 out of 53 patients and biochemical markers of cholestasis and hepatocellular damage (GGTP, AST, ALT, ALP and serum bilirubin level). The beneficial effect of UDCA on the liver histology was assessed in 29 out of 53 patients after minimum period of 12 months of therapy commonly in the patients group with ASH and AS. Improvement was found only in 12/53 patients with alcoholic liver diseases (ALD), but not in the patients group with alcoholic liver cirrhosis. Our results strongly suggest that long-term treatment with UDCA improves biochemical and clinical parameters in alcoholic liver disease. Histological improvements was partial and in minority of patients. Conclusion: The use of UDCA in the treatment of ALD appears to be safe and without side effects in our patients group.