CHARACTERIZATION OF PATIENTS WITH A COMPLETE BIOCHEMICAL RESPONSE TO URSODEOXYCHOLIC ACID

Ursodeoxycholic acid (UDCA) leads to biochemical and clinical improvem ent in many patients with primary biliary cirrhosis (PBC); although, t he response is variable. This study compared UDCA treated patients wit h complete normalisation of biochemical functions to those without suc h improvement. Of the 65 patients receiving UDCA, 12 (19%) showed norm alisation of liver biochemical functions at two years. The remaining 5 3 patients showed a less complete response. Mean (SD) alkaline phospha tase and total serum bilirubin values were significantly lower at entr y in the patients whose liver biochemistry tests normalised (912 (732) U/l v 1417 (1021) U/l, p=0.003, and 0.7 (12.1 (5.2) mu mol/l v 38.9 ( 48.5) mu mol/l, p=0.0002, respectively), and percentage of UDCA in bil iary bile acid was higher (56.3 (9.5)% v 38.3 (21.1)%, p=0.03). Patien ts with biochemically and histologically less severe disease, and grea ter enrichment of biliary bile with UDCA, are more likely to respond f avourably to the drug. The main objective of continued study will be t o find out if normal Liver biochemical functions can retard disease pr ogression. The association of greater UDCA enrichment with complete bi ochemical responses suggests that higher doses of UDCA should be evalu ated.