Ursodeoxycholic acid vs. chenodeoxycholic acid as cholesterol gallstone-dissolving agents: A comparative randomized study

✍ Scribed by Enrico Roda; Franco Bazzoli; Antonio M. Morselli Labate; Giuseppe Mazzella; Aldo Roda; Claudia Sama; Davide Festi; Rita Aldini; Francesco Taroni; Luigi Barbara

• Book ID: 102850432
• Publisher: John Wiley and Sons
• Year: 1982
• Tongue: English
• Weight: 687 KB
• Volume: 2
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840020611

✦ Synopsis

Cholesterol gallstones are dissolved in man by chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA). To test the comparative efficacy of these two cholelitholytic bile acids, 223 gallstone patients were randomly treated with either UDCA or CDCA at two different doses: 7 to 8 mg per kg per day and 14 to 15 mg per kg per day. Efficacy and factors influencing dissolution (dose, size of the stones, and time) were evaluated after 3,6, and 12 months of treatment. UDCA was significantly more efficacious than was CDCA after 3 and 6 months of treatment, whereas after 12 months, no significant differences were observed. UDCA was equally effective at high and low doses, both on small and large stones. CDCA was significantly more effective at high doses and on small stones. Seventy-four per cent of the total dissolutions with UDCA and 42% with CDCA occurred within the first 6 months of treatment. Diarrhea and hypertransaminasemia occurred only in the CDCA-treated patients. We conclude that UDCA seems to be the bile acid of choice in dissolving cholesterol gallstones.

Chenodeoxycholic acid (CDCA) and its 7P-epimer, ursodeoxycholic acid (UDCA), are efficacious in dissolvinn cholesterol gallstones (1-12). SUBJECTS

Methods

CDCA has been shown to be effective at a daily dose of 15 mg per kg (4, 9, 13,14).

UDCA, the more recently introduced cholelitholytic bile acid, seems to be effective at a lower dosage (15, 16) and does not induce either diarrhea (17,18) or hypertransaminasemia (5, l l ) , which occurs in some of the patients treated with CDCA.

Although CDCA and UDCA have been widely studied, to date, little is known about the comparative efficacy of these two cholelitholytic agents.

In this paper, we report the 1 year follow-up on 223 gallstone patients randomly treated with either CDCA or UDCA.

To define possibly the bile acid of choice in the treatment of cholesterol gallstones, we also compare the efficacy of UDCA and CDCA in relation to dose, size of the stones, and duration of treatment. Treatment-induced side effects were also evaluated.