Original ResearchClinical—LiverEfficacy of Ursodeoxycholic Acid in Treating Intrahepatic Cholestasis of Pregnancy: A Meta-analysis
Section snippets
Patients and Methods
Meta-analyses were conducted according to a predetermined protocol following the recommendations of Sacks et al15 but were limited to English language randomized controlled trials (RCTs). To collect data for the meta-analyses, a standardized questionnaire was sent to the corresponding author of each of the selected RCTs.
Studied Population
Nine RCTs including 489 patients with ICP were selected and analyzed.18, 19, 20, 21, 22, 23, 24, 25, 26 Out of the 489 patients, 35 patients who received an association of UDCA and S-adenosyl-methionine were excluded from the meta-analysis. Out of the remaining 454 patients, 207 received UDCA alone, 70 received the placebo alone, 42 received cholestyramine, 36 received dexamethasone for 1 week and then placebo for 2 weeks, 65 received S-adenosyl-methionine, and 34 received no treatment. We sent
Discussion
Although UDCA appears as the most efficient treatment of ICP, the evidence of its benefit on pruritus is still debated, and the only previous meta-analysis failed to provide significant results.27 Moreover, the role of UDCA in preventing severe fetal outcome has never been demonstrated.28 In the previously published systematic review on this topic led by Burrows et al (update available on www.cochrane.org), the authors concluded that “inconsistent and inadequate reporting of results precluded
Acknowledgments
The authors thank Adam Smith for reviewing the English text.
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This article has an accompanying continuing medical education activity on page e13. Learning Objective: Upon completion of the CME activity, successful learners will be able to prescribe a medical treatment for intrahepatic cholestasis of pregnancy (ICP).
Conflicts of interest The authors disclose no conflicts.