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Ursodeoxycholic acid does not inhibit liver overgrowth
Ursodeoxycholic acid may not be a viable treatment option for some patients with polycystic liver disease, according to research recently published in the Journal of Hepatology.
“We knew that ursodeoxycholic acid inhibits hyperproliferation in [polycystic liver disease] cholangiocytes and had treated a severe case who benefited from ursodeoxycholic acid with reduced liver volume,” Joost P.H. Drenth, MD, of the department of gastroenterology and hepatology, Raboud University Medical Center, Nijmegen, Netherlands, told Healio.com/Hepatology. “We found that 6 months of the drug did not stop the liver from growing. Patients with [polycystic liver disease] and polycystic kidneys fared better than patients with [polycystic liver disease] alone.”
For this randomized controlled trial, researchers studied 32 patients with polycystic liver disease (PLD) aged between 18 and 80 years from three European cities with total liver volume (TLV) greater than or equal to 2,500 mL. Half had autosomal dominant polycystic kidney disease (ADPKD) and half with autosomal dominant polycystic liver disease. Patients were either placed in a control group or given either 15 mg/kg/day to 20 mg/kg/day of ursodeoxycholic acid (UDCA) for 24 weeks and were evaluated at 0, 4, 12, 24 and 36 weeks.
Researchers also noted:
- proportional TLV increased by 4.6 ± 7.7% (mean TLV increased from 6,697 mL to 6,954 mL) after 24 weeks of UDCA compared with 3.1 ± 3.8% (mean TLV increased from 5,512 mL to 5,724 mL) in the control group (P = .493);
- liver cyst volume (LCV) remained unchanged after 24 weeks between controls and UDCA treated patients (P = .848); and
- UDCA inhibited LCV growth in ADPKD patients compared with ADPKD controls (P = .049).
In addition to the irrelevant impacts of UDCA on livers, researchers also observed:
- minor increases in PLD and GI symptom scores in both groups;
- ·no changes in biochemical tests (with the exception of gammaglutamyltransferase) were noted from the study’s onset to 24 weeks;
- total kidney volume of ADPKD patients was not impacted, regardless of group;
- the height total kidney volume increased in the control group but not in those patients taking UDCA; and
- a six-point increase in the quality of life of those patients taking UDCA and a four-point decrease among those who did not.
“Surgical management is not effective,” Drenth told Healio.com/Hepatology. Another treatment option, somatostatin analogues, is somewhat effective in lowering TLV by approximately 5% over a period from 6 to 12 months, researchers wrote. However, they wrote it does not work in all patients, can be cost-prohibitive and can potentially cause gallstones, diarrhea and glucose intolerance. For these reasons, researchers wrote, other treatments must be found. – by Janel Miller
Disclosure: This study was funded by Zambon-Netherlands B. V., Amersfoort, Netherlands. The researchers report no relevant financial disclosures.