Budesonide combined with UDCA to improve liver histology in primary biliary cirrhosis: A three‐year randomized trial†
Open accessAbstract
Ursodeoxycholic acid (UDCA) is a safe medical therapy for primary biliary cirrhosis (PBC), but its effect on liver histology remains uncertain. Budesonide is a glucocorticoid with high receptor activity and high first-pass metabolism in liver. We evaluated the combination of budesonide and UDCA on liver histology and compared this with UDCA alone in a 3-year prospective, randomized, open multicenter study. Patients with PBC (n = 77), at stages I to III, were randomized into 2 treatment arms, A (n = 41): budesonide 6 mg/d and UDCA 15 mg/kg/d and B (n = 36): UDCA 15 mg/kg/d. Liver histology was assessed at the beginning and at the end of the study. Liver function tests and glucose and cortisol values were determined every 4 months. Paired liver biopsy specimens were available from 69 patients (A = 37 and B = 32). Stage improved 22% in group A but deteriorated 20% in group B (P = .009). Fibrosis decreased 25% in group A but increased 70% in group B (P = .0009). S-PIIINP decreased significantly in group A. Inflammation decreased in both groups, 34% in group A (P = .02), but only 10% in group B (P = NS). Serum liver enzymes decreased significantly in both treatment arms. Bilirubin values rose in group B but stayed stable in group A (A/B P = .002). A mild systemic glucocorticoid effect from budesonide was evident after 2 years. In conclusion, budesonide combined with UDCA improved liver histology, whereas the effect of UDCA alone was mainly on laboratory values. Studies with longer follow-up using a combination of budesonide and UDCA are warranted to confirm safety and effects.
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In a subsequent 3-year randomised non-blinded study in non-cirrhotic PBC patients (n=77), budesonide 6 mg/day plus UDCA (n=46) was associated with a 25% regression in liver fibrosis.
“Moreover, in a subsequent 3-year randomised non-blinded study performed in non-cirrhotic PBC patients (n=77), budesonide 6 mg/day plus UDCA (n=46) was associated with a 25% regression in liver fibrosis.160”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [160]
In that study, there was a high rate of fibrosis progression (an increase of 70%) in patients receiving UDCA monotherapy.
“However, despite encouraging results, note must be taken of a high rate of fibrosis progression (an increase of 70%) in patients receiving UDCA monotherapy.”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [160]
Cites
An Algorithm for the Grading of Activity in Chronic Hepatitis C
Bédossa, P., & Poynard, T. (1996) · Hepatology · doi:10.1002/hep.510240201 · Cited by 4,054 · see citing works
Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis)
Ludwig, J., Dickson, E. R., & McDonald, G. S. A. (1978) · Virchows Archiv A Pathological Anatomy and Histology · doi:10.1007/bf00432479 · Cited by 753 · see citing works
Poupon, R., Lindor, K., Cauch-Dudek, K., Dickson, E., Poupon, R., & Heathcote, E. (1997) · Gastroenterology · doi:10.1016/s0016-5085(97)70183-5 · Cited by 648 · see citing works
Oral Budesonide for Active Crohn's Disease
Greenberg, G. R., Feagan, B. G., Martin, F., Sutherland, L. R., Thomson, A. B. R., Williams, C., Nilsson, L., & Persson, T. (1994) · New England Journal of Medicine · doi:10.1056/nejm199409293311303 · Cited by 564 · see citing works
Ursodiol for the Long-Term Treatment of Primary Biliary Cirrhosis
Poupon, R. E., Poupon, R., & Balkau, B. (1994) · New England Journal of Medicine · doi:10.1056/nejm199405123301903 · Cited by 497 · see citing works
Kaplan, M. M. (1996) · New England Journal of Medicine · doi:10.1056/nejm199611213352107 · Cited by 455 · see citing works
Corpechot, C., Carrat, F., Bonnand, A.-M., Poupon, R. E., & Poupon, R. (2000) · Hepatology · doi:10.1053/jhep.2000.20240 · Cited by 316 · see citing works
Goulis, J., Leandro, G., & Burroughs, A. K. (1999) · The Lancet · doi:10.1016/s0140-6736(98)11293-x · Cited by 315 · see citing works
COMBES, B., Carithers, R. L., Maddrey, W. C., Lin, D., McDonald, M. F., Wheeler, D. E., Eigenbrodt, E. H., Muñoz, S. J., Rubin, R., Garcia-Tsao, G., et al. (1995) · Hepatology · doi:10.1016/0270-9139(95)90294-5 · Cited by 302 · see citing works
Pharmacokinetics and metabolism of budesonide, a selective glucocorticoid.
Ryrfeldt, Å., Andersson, P., Edsbäcker, S., Tönnesson, M., Davies, D., & Pauwels, R. (1982) · PubMed · Cited by 301 · see citing works
Ursodeoxycholic acid for primary biliary cirrhosis
Rudić, J. S., Poropat, G., Krstic, M. N., Bjelaković, G., & Gluud, C. N. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000551.pub3 · Cited by 274 · see citing works
Leuschner, M., Maier, K., Schlichting, J., Strahl, S., Herrmann, G., Dahm, H. H., Ackermann, H., Happ, J., & Leuschner, U. (1999) · Gastroenterology · doi:10.1016/s0016-5085(99)70351-3 · Cited by 247 · see citing works
Poupon, R. E., Lindor, K. D., Parés, A. R., Chazouillères, O., Poupon, R. Y., & Heathcote, E. J. (2003) · Journal of Hepatology · doi:10.1016/s0168-8278(03)00192-2 · Cited by 215 · see citing works
Time course of histological progression in primary biliary cirrhosis
Locke, G. R., Therneau, T. M., Ludwig, J., Dickson, E. R., & Lindor, K. D. (1996) · Hepatology · doi:10.1002/hep.510230108 · Cited by 184 · see citing works
Angulo, P., Jorgensen, R. A., Keach, J. C., Dickson, R. E., Smith, C., & Lindor, K. D. (2000) · Hepatology · doi:10.1002/hep.510310209 · Cited by 179 · see citing works
Corpechot, C., Carrat, F., Poupon, R., & Poupon, R. (2002) · Gastroenterology · doi:10.1053/gast.2002.31880 · Cited by 169 · see citing works
Hempfling, W., Grünhage, F., Dilger, K., Reichel, C., Beuers, U. H., & Sauerbruch, T. (2003) · Hepatology · doi:10.1053/jhep.2003.50266 · Cited by 163 · see citing works
Budesonide is metabolized by cytochrome P450 3A (CYP3A) enzymes in human liver.
Jönsson, G., Åström, A., & Andersson, P. (1995) · Drug Metabolism and Disposition · doi:10.1016/s0090-9556(25)06497-9 · Cited by 158 · see citing works
Leuschner, M., Güldütuna, S., You, T., Hübner, K., Bhatti, S., & Leuschner, U. (1996) · Journal of Hepatology · doi:10.1016/s0168-8278(96)80327-8 · Cited by 119 · see citing works
Leuschner, M., Dietrich, C. F., You, T., Seidl, C., Raedle, J., Herrmann, G., Ackermann, H., & Leuschner, U. (2000) · Gut · doi:10.1136/gut.46.1.121 · Cited by 81 · see citing works
Combes, B., Carithers, R. L., Maddrey, W. C., Lin, D. P., McDonald, M. F., Wheeler, D. E., Eigenbrodt, E. H., oz, S. J. M., Rubin, R., Garcia-Tsao, G., et al. (1995) · European Journal of Gastroenterology & Hepatology · doi:10.1097/00042737-199511000-00024 · Cited by 72 · see citing works
Papatheodoridis, G., Hadziyannis, E. S., Deutsch, M. J., & Hadziyannis, S. J. (2002) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2002.05923.x · Cited by 55 · see citing works
Mm, K. (1987) · PubMed · Cited by 36 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
EASL Clinical Practice Guidelines: management of cholestatic liver diseases
European Association for the Study of the Liver (2009) · Journal of Hepatology · doi:10.1016/j.jhep.2009.04.009 · Cited by 1,729 · see citing works
Hirschfield, G. M., Beuers, U., Corpechot, C., Invernizzi, P., Jones, D., Marzioni, M., & Schramm, C. (2017) · Journal of Hepatology · doi:10.1016/j.jhep.2017.03.022 · Cited by 1,480 · see citing works
Kaplan, M. M., & Gershwin, M. E. (2005) · New England Journal of Medicine · doi:10.1056/nejmra043898 · Cited by 1,144 · see citing works
New paradigms in the treatment of hepatic cholestasis: from UDCA to FXR, PXR and beyond
Beuers, U., Trauner, M., Jansen, P., & Poupon, R. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.02.023 · Cited by 537 · see citing works
Corpechot, C., Chazouillères, O., & Poupon, R. (2011) · Journal of Hepatology · doi:10.1016/j.jhep.2011.02.031 · Cited by 460 · see citing works
Bile acid transporters and regulatory nuclear receptors in the liver and beyond
Halilbasic, E., Claudel, T., & Trauner, M. A. (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2012.08.002 · Cited by 397 · see citing works
Tsukada, S., Parsons, C. J., & Rippe, R. A. (2005) · Clinica Chimica Acta · doi:10.1016/j.cca.2005.06.014 · Cited by 353 · see citing works
Hirschfield, G. M., Dyson, J. K., Alexander, G. J. M., Chapman, M. H., Collier, J., Hübscher, S., Patanwala, I., Pereira, S. P., Thain, C., Thorburn, D., et al. (2018) · Gut · doi:10.1136/gutjnl-2017-315259 · Cited by 347 · see citing works
Primary biliary cirrhosis: A 2010 update
Poupon, R. Y. (2010) · Journal of Hepatology · doi:10.1016/j.jhep.2009.11.027 · Cited by 272 · see citing works
Hirschfield, G. M., & Heathcote, E. J. (2010) · Wiley eBooks · doi:10.1002/9781444314403.ch32 · Cited by 260 · see citing works
Chazouillères, O., Wendum, D., Serfaty, L., Rosmorduc, O., & Poupon, R. (2006) · Journal of Hepatology · doi:10.1016/j.jhep.2005.10.017 · Cited by 194 · see citing works
Kumagi, T., & Heathcote, E. J. (2008) · Orphanet Journal of Rare Diseases · doi:10.1186/1750-1172-3-1 · Cited by 179 · see citing works
Hohenester, S. D., Elferink, R. P. J. O., & Beuers, U. H. (2009) · Seminars in Immunopathology · doi:10.1007/s00281-009-0164-5 · Cited by 176 · see citing works
Endocrine and liver interaction: the role of endocrine pathways in NASH
Loria, P., Carulli, L., Bertolotti, M., & Lonardo, A. (2009) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2009.33 · Cited by 148 · see citing works
Long-term follow-up of antimitochondrial antibody-positive autoimmune hepatitis
O'Brien, C., Joshi, S., Feld, J. J., Guindi, M., Dienes, H. P., & Heathcote, E. J. (2008) · Hepatology · doi:10.1002/hep.22380 · Cited by 146 · see citing works
Nuclear receptors as therapeutic targets in cholestatic liver diseases
Zollner, G., & Trauner, M. (2009) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.2008.00030.x · Cited by 146 · see citing works
Why Bile Acids Are So Important in Non-Alcoholic Fatty Liver Disease (NAFLD) Progression
Gottlieb, A., & Canbay, A. E. (2019) · Cells · doi:10.3390/cells8111358 · Cited by 138 · see citing works
You, H., Ma, X., Efe, C., Wang, G., Jeong, S.-H., Abe, K., Duan, W., Chen, S., Kong, Y., Zhang, D., et al. (2022) · Hepatology International · doi:10.1007/s12072-021-10276-6 · Cited by 133 · see citing works
New Treatment Paradigms in Primary Biliary Cholangitis
Levy, C., Manns, M. P., & Hirschfield, G. M. (2023) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2023.02.005 · Cited by 141 · see citing works
Hockenbery, D. M., Cruickshank, S., Rodell, T. C., Gooley, T. A., Schuening, F., Rowley, S. D., David, D. S., Brunvand, M. M., Berryman, B., Abhyankar, S., et al. (2007) · Blood · doi:10.1182/blood-2006-05-021139 · Cited by 124 · see citing works
Liver alkaline phosphatase: a missing link between choleresis and biliary inflammation
Poupon, R. (2015) · Hepatology · doi:10.1002/hep.27715 · Cited by 120 · see citing works
Primary biliary cirrhosis: Pathophysiology, clinical presentation and therapy
Purohit, T. (2015) · World Journal of Hepatology · doi:10.4254/wjh.v7.i7.926 · Cited by 118 · see citing works
Arenas, F., Hervías, I., Úriz, M., Joplin, R., Prìeto, J., & Medina, J. F. (2008) · Journal of Clinical Investigation · doi:10.1172/jci33156 · Cited by 116 · see citing works
The challenges of primary biliary cholangitis: What is new and what needs to be done
Terziroli Beretta-Piccoli, B., Mieli-Vergani, G., Vergani, D., Vierling, J. M., Adams, D., Alpini, G., Banales, J. M., Beuers, U., Björnsson, E., Bowlus, C., et al. (2019) · Journal of Autoimmunity · doi:10.1016/j.jaut.2019.102328 · Cited by 114 · see citing works
Nuclear Receptors as New Perspective for the Management of Liver Diseases
Trauner, M., & Halilbasic, E. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.02.044 · Cited by 114 · see citing works
Guidelines for the management of primary biliary cirrhosis
Cirrhosis, W. S. (. V. F. C. P. G. F. P. B. (2014) · Hepatology Research · doi:10.1111/hepr.12270 · Cited by 111 · see citing works
Hirschfield, G. M., Beuers, U., Kupcinskas, L., Ott, P., Bergquist, A., Färkkilä, M., Manns, M. P., Parés, A., Spengler, U., Stiess, M., et al. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2020.09.011 · Cited by 108 · see citing works
Self-citationNuclear Receptors as Drug Targets in Cholestatic Liver Diseases
Halilbasic, E., Baghdasaryan, A., & Trauner, M. A. (2013) · Clinics in Liver Disease · doi:10.1016/j.cld.2012.12.001 · Cited by 98 · see citing works
Management of cholestatic disease in 2017
de Vries, E., & Beuers, U. H. (2017) · Liver International · doi:10.1111/liv.13306 · Cited by 89 · see citing works
Liver transplantation in PBC and PSC: Indications and disease recurrence
Carbone, M., & Neuberger, J. (2011) · Clinics and Research in Hepatology and Gastroenterology · doi:10.1016/j.clinre.2011.02.007 · Cited by 89 · see citing works
Nuclear receptors as drug targets in cholestasis and drug-induced hepatotoxicity
Zollner, G., Wagner, M., & Trauner, M. A. (2010) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2010.03.005 · Cited by 89 · see citing works
Silveira, M. G., Brunt, E. M., Heathcote, J., Gores, G. J., Lindor, K. D., & Mayo, M. J. (2010) · Hepatology · doi:10.1002/hep.23637 · Cited by 87 · see citing works
Karlsen, T. H., Vesterhus, M. N., & Boberg, K. M. (2013) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12581 · Cited by 86 · see citing works
S2k Leitlinie Autoimmune Lebererkrankungen
Authors, Collaborators:, durch:, E. B., Deutsche Gesellschaft für Gastroenterologie, V. U. S. (. (., (DGIM), D. G. F. I. M., (DCCV), D. M. C. U. V., e.V., D. L., (DEGUM), D. G. F. U. I. D. M., (DGE-BV), D. G. F. E. U. B. V., (DGKJ), D. G. F. K. U. J., et al. (2017) · Zeitschrift für Gastroenterologie · doi:10.1055/s-0043-120199 · Cited by 85 · see citing works
Diagnosis and Management of Cholestatic Liver Disease
Heathcote, E. J. (2007) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2007.05.008 · Cited by 75 · see citing works
Novel and emerging therapies for cholestatic liver diseases
Goldstein, J., & Levy, C. (2018) · Liver International · doi:10.1111/liv.13880 · Cited by 74 · see citing works
Drug Therapies for Chronic Cholestatic Liver Diseases
Wagner, M., & Fickert, P. (2019) · The Annual Review of Pharmacology and Toxicology · doi:10.1146/annurev-pharmtox-010818-021059 · Cited by 72 · see citing works
Primary biliary cholangitis: Old and novel therapy
Floreani, A., & Mangini, C. (2017) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2017.06.020 · Cited by 75 · see citing works
Recurrence of Diseases Following Orthotopic Liver Transplantation
Kotlyar, D. S., Campbell, M. S., & Reddy, K. R. (2006) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2006.00586.x · Cited by 68 · see citing works
Prevalence of Primary Biliary Cirrhosis–Autoimmune Hepatitis Overlap Syndrome
Bonder, A., Retana, A., Winston, D. M., Leung, J., & Kaplan, M. M. (2011) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2011.03.019 · Cited by 67 · see citing works
Unmet clinical need in autoimmune liver diseases
Dyson, J. K., Webb, G., Hirschfield, G. M., Lohse, A., Beuers, U., Lindor, K., & Jones, D. E. J. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2014.09.010 · Cited by 66 · see citing works
Medical treatment of cholestatic liver diseases: From pathobiology to pharmacological targets
Paumgartner, G. (2006) · World Journal of Gastroenterology · doi:10.3748/wjg.v12.i28.4445 · Cited by 63 · see citing works
Mechanisms and molecules: What are the treatment targets for primary biliary cholangitis?
Mayo, M. J. (2022) · Hepatology · doi:10.1002/hep.32405 · Cited by 58 · see citing works
Primary biliary cholangitis: A tale of epigenetically-induced secretory failure?
Rodrigues, P. M., Perugorria, M. J., Santos‐Laso, Á., Bujanda, L., Beuers, U. H., & Bañales, J. M. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.08.020 · Cited by 58 · see citing works
Park, J. W., Kim, J. H., Kim, S. E., Jung, J. H., Jang, M. K., Park, S. H., Lee, M. S., Kim, H. S., Suk, K. T., & Kim, D. J. (2022) · Biomedicines · doi:10.3390/biomedicines10061288 · Cited by 58 · see citing works
Clinical application of transcriptional activators of bile salt transporters
Baghdasaryan, A., Chiba, P., & Trauner, M. A. (2013) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2013.12.001 · Cited by 56 · see citing works
Bowlus, C. L., Yang, G., Liu, C. H., Johnson, C. R., Dhaliwal, S. S., Frank, D., Levy, C., Peters, M. G., Vierling, J. M., & Gershwin, M. E. (2019) · Journal of Autoimmunity · doi:10.1016/j.jaut.2019.04.005 · Cited by 56 · see citing works
Pharmacological interventions for primary biliary cholangitis
Saffioti, F., Gurusamy, K. S., Eusebi, L. H., Tsochatzis, E. A., Davidson, B. R., & Thorburn, D. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011648.pub2 · Cited by 54 · see citing works
Rabahi, N., Chrétien, Y., Gaouar, F., Wendum, D., Serfaty, L., Chazouillères, O., Corpechot, C., & Poupon, R. Y. (2010) · Gastroentérologie Clinique et Biologique · doi:10.1016/j.gcb.2010.02.004 · Cited by 53 · see citing works
Bile acid regulation: A novel therapeutic strategy in non-alcoholic fatty liver disease
Yu, Q., Jiang, Z., & Zhang, L. (2018) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2018.04.005 · Cited by 53 · see citing works
Obeticholic acid for the treatment of primary biliary cholangitis
Ali, A. H., & Lindor, K. D. (2016) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2016.1218471 · Cited by 50 · see citing works
Obeticholic acid and budesonide for the treatment of primary biliary cirrhosis
Silveira, M. G., & Lindor, K. D. (2014) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2014.873404 · Cited by 50 · see citing works
Treatment of autoimmune liver disease: current and future therapeutic options
Trivedi, P. J., & Hirschfield, G. M. (2013) · Therapeutic Advances in Chronic Disease · doi:10.1177/2040622313478646 · Cited by 49 · see citing works
Value of Autoantibody Analysis in the Differential Diagnosis of Chronic Cholestatic Liver Disease
Milkiewicz, P., Buwaneswaran, H., Coltescu, C., Shums, Z., Norman, G. L., & Heathcote, E. J. (2009) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2009.07.012 · Cited by 47 · see citing works
Clinical features and management of primary biliary cirrhosis
Crosignani, A., Battezzati, P. M., Invernizzi, P., Selmi, C. F., Prina, E., & Podda, M. (2008) · World Journal of Gastroenterology · doi:10.3748/wjg.14.3313 · Cited by 46 · see citing works
Cholestasis and cholestatic syndromes
OʼLeary, J. G., & Pratt, D. S. (2007) · Current Opinion in Gastroenterology · doi:10.1097/mog.0b013e3280d942d8 · Cited by 45 · see citing works
Role of Bile Acids and the Biliary HCO3− Umbrella in the Pathogenesis of Primary Biliary Cholangitis
van Niekerk, J., Kersten, R., & Beuers, U. H. (2018) · Clinics in Liver Disease · doi:10.1016/j.cld.2018.03.013 · Cited by 44 · see citing works
Inflammation: Cause or consequence of chronic cholestatic liver injury
Woolbright, B. L. (2020) · Food and Chemical Toxicology · doi:10.1016/j.fct.2020.111133 · Cited by 38 · see citing works
Montaño‐Loza, A. J., & Corpechot, C. (2020) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2020.06.062 · Cited by 40 · see citing works
New Therapies for Primary Biliary Cirrhosis
Floreani, A., Franceschet, I., Perini, L., Cazzagon, N., Gershwin, M. E., & Bowlus, C. L. (2014) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-014-8456-5 · Cited by 37 · see citing works
Czul, F., Peyton, A., & Levy, C. (2013) · Clinics in Liver Disease · doi:10.1016/j.cld.2012.12.003 · Cited by 37 · see citing works
Medical Treatment of Cholestatic Liver Disease
Paumgartner, G., & Pusl, T. (2008) · Clinics in Liver Disease · doi:10.1016/j.cld.2007.11.013 · Cited by 37 · see citing works
Fibrate treatment for primary biliary cirrhosis
Cuperus, F. J. C., Halilbasic, E., & Trauner, M. (2014) · Current Opinion in Gastroenterology · doi:10.1097/mog.0000000000000056 · Cited by 36 · see citing works
Nuclear Receptors in Acute and Chronic Cholestasis
Gonzalez‐Sanchez, E., Firrincieli, D., Housset, C., & Chignard, N. (2015) · Digestive Diseases · doi:10.1159/000371688 · Cited by 36 · see citing works
Advances in pharmacotherapy for primary biliary cirrhosis
Mousa, H., Lleo, A., Invernizzi, P., Bowlus, C., & Gershwin, M. (2014) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2015.998650 · Cited by 36 · see citing works
Current Concepts in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis
Sclair, S. N., Little, E. C., & Levy, C. (2015) · Clinical and Translational Gastroenterology · doi:10.1038/ctg.2015.33 · Cited by 33 · see citing works
Primary biliary cirrhosis in adults
Momah, N., & Lindor, K. D. (2014) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.2014.888950 · Cited by 33 · see citing works
Novel therapeutics for primary biliary cholangitis: Toward a disease-stage-based approach
Mousa, H. S., Carbone, M., Malinverno, F., Ronca, V., Gershwin, M. E., & Invernizzi, P. (2016) · Autoimmunity Reviews · doi:10.1016/j.autrev.2016.07.003 · Cited by 33 · see citing works
Primary biliary cirrhosis in 2014
Flores, A. G., & Mayo, M. J. (2014) · Current Opinion in Gastroenterology · doi:10.1097/mog.0000000000000058 · Cited by 34 · see citing works
Beuers, U. H., Kullak-Ublick, G. A., Pusl, T., Rauws, E. A., & Rust, C. (2008) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-008-8085-y · Cited by 32 · see citing works
Xiao, Y., Yan, W., Zhou, K., Cao, Y. L., & Cai, W. (2016) · Digestive and Liver Disease · doi:10.1016/j.dld.2016.03.022 · Cited by 32 · see citing works
Liver transplantation in primary biliary cirrhosis.
Milkiewicz, P. (2008) · Clinical Liver Disease · doi:10.1016/j.cld.2008.02.015 · Cited by 14 · see citing works
Kida, A., & McDonald, G. B. (2012) · Seminars in Hematology · doi:10.1053/j.seminhematol.2011.10.006 · Cited by 30 · see citing works
Recent advances in the diagnosis and treatment of primary biliary cholangitis
Huang, Y.-Q. (2016) · World Journal of Hepatology · doi:10.4254/wjh.v8.i33.1419 · Cited by 30 · see citing works
Rosales, R., Romero, M. R., Vaquero, J., Monte, M. J., Requena, P., Martínez‐Augustin, O., de Medina, F. S., & Marı́n, J. J. G. (2013) · Biochemical Pharmacology · doi:10.1016/j.bcp.2013.01.001 · Cited by 30 · see citing works
Patel, A., & Seetharam, A. (2016) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2016.10.001 · Cited by 25 · see citing works
New treatments/targets for primary biliary cholangitis
Corpechot, C., Poupon, R. Y., & Chazouillères, O. (2019) · JHEP Reports · doi:10.1016/j.jhepr.2019.05.005 · Cited by 30 · see citing works
New Therapeutic Targets in Autoimmune Cholangiopathies
Gerussi, A., Luca, M. D., Cristoferi, L., Ronca, V., Mancuso, C., Milani, C., D’Amato, D., O'Donnell, S. E., Carbone, M., & Invernizzi, P. (2020) · Frontiers in Medicine · doi:10.3389/fmed.2020.00117 · Cited by 30 · see citing works
Current pharmacotherapy for cholestatic liver disease
Carey, E. J., & Lindor, K. D. (2012) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2012.736491 · Cited by 29 · see citing works
Persistent reduction of mucosal‐associated invariant T cells in primary biliary cholangitis
Setsu, T., Yamagiwa, S., Tominaga, K., Kimura, N., Honda, H., Kamimura, H., Tsuchiya, A., Takamura, M., & Terai, S. (2017) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.14076 · Cited by 29 · see citing works
Chascsa, D. M. H., & Lindor, K. D. (2020) · Journal of Gastroenterology · doi:10.1007/s00535-020-01664-0 · Cited by 28 · see citing works
The Management of Cholestatic Liver Diseases: Current Therapies and Emerging New Possibilities
Mazzetti, M., Marconi, G., Mancinelli, M., Benedetti, A., Marzioni, M., & Maroni, L. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10081763 · Cited by 28 · see citing works
Treatment in primary biliary cholangitis: Beyond ursodeoxycholic acid
van Hooff, M. C., Werner, E., & van der Meer, A. J. (2024) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2024.01.030 · Cited by 27 · see citing works
Primary biliary cirrhosis and bile acids
Corpechot, C. (2012) · Clinics and Research in Hepatology and Gastroenterology · doi:10.1016/s2210-7401(12)70016-5 · Cited by 27 · see citing works
Treatment of Primary Biliary Cirrhosis: Therapy with Choleretic and Immunosuppressive Agents
Silveira, M. G., & Lindor, K. D. (2008) · Clinics in Liver Disease · doi:10.1016/j.cld.2008.02.008 · Cited by 27 · see citing works
Guidelines on the Diagnosis and Management of Primary Biliary Cholangitis (2021)
You, H., Duan, W., Li, S., Lv, T., Chen, S., Lu, L., Ma, X., Han, Y., Nan, Y., Xu, X., et al. (2023) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2022.00347 · Cited by 29 · see citing works
Novel Aspects in the Management of Cholestatic Liver Diseases
Chazouillères, O. (2016) · Digestive Diseases · doi:10.1159/000444544 · Cited by 26 · see citing works
Primary Biliary Cholangitis: Medical and Specialty Pharmacy Management Update
Bowlus, C. L., Kenney, J. T., Rice, G. K., & Navarro, R. P. (2016) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2016.22.10-a-s.s3 · Cited by 26 · see citing works
Pharmacokinetics and bone effects of budesonide in primary biliary cirrhosis
Rautiainen, H., Färkkilä, M. A., Neuvonen, M., Sane, T., Karvonen, A.-L., Nurmi, H., Kärkkäinen, P. A., Neuvonen, P. J., & Backman, J. T. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.03155.x · Cited by 24 · see citing works
Self-citationBittencourt, P. L., Cançado, E. L. R., Couto, C. A., Levy, C., Porta, G., Silva, A. E. B., Terrabuio, D. R. B., de Carvalho‐Filho, R. J., CHAVES, D. M., Miura, I. K., et al. (2015) · Arquivos de Gastroenterologia · doi:10.1590/s0004-28032015000500002 · Cited by 23 · see citing works
Alvaro, D., Carpino, G., Craxı̀, A., Floreani, A., Moschetta, A., & Invernizzi, P. (2020) · Liver International · doi:10.1111/liv.14627 · Cited by 23 · see citing works
The immunological landscape of primary biliary cholangitis: Mechanisms and therapeutic prospects
Ronca, V., Davies, S. P., Oo, Y. H., & Lleo, A. (2025) · Hepatology · doi:10.1097/hep.0000000000001225 · Cited by 22 · see citing works
Pharmacotherapy of cholestatic liver diseases
Paumgartner, G. (2010) · Journal of Digestive Diseases · doi:10.1111/j.1751-2980.2010.00427.x · Cited by 22 · see citing works
Concept on the pathogenesis and treatment of primary biliary cirrhosis.
Reshetnyak, V. (2006) · World Journal of Gastroenterology · doi:10.3748/wjg.v12.i45.7250 · Cited by 26 · see citing works
Overlap syndromes with autoimmune hepatitis in chronic cholestatic liver diseases
Silveira, M. G., & Lindor, K. D. (2007) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.1.2.329 · Cited by 23 · see citing works
Cholestasis and cholestatic syndromes
Rutherford, A., & Pratt, D. S. (2006) · Current Opinion in Gastroenterology · doi:10.1097/01.mog.0000218956.63311.47 · Cited by 22 · see citing works
Gerussi, A., D’Amato, D., Cristoferi, L., O’Donnell, S. E., Carbone, M., & Invernizzi, P. (2019) · Annals of Hepatology · doi:10.1016/j.aohep.2019.09.009 · Cited by 20 · see citing works
Yao, T. T., Qian, J., & Wang, G.-Q. (2020) · Medicina Clínica · doi:10.1016/j.medcli.2020.03.013 · Cited by 19 · see citing works
Diagnostic criteria and long-term outcomes in AIH-PBC variant syndrome under combination therapy
Stoelinga, A., Biewenga, M., Drenth, J. P. H., Verhelst, X., van der Meer, A. J. P., de Boer, Y. S., Bouma, G., de Vries, E. S., Verdonk, R. C., van den Berg, A. P., et al. (2024) · JHEP Reports · doi:10.1016/j.jhepr.2024.101088 · Cited by 20 · see citing works
Update on pharmacotherapies for cholestatic liver disease
Ali, A. H., Tabibian, J. H., & Lindor, K. D. (2016) · Hepatology Communications · doi:10.1002/hep4.1013 · Cited by 19 · see citing works
- Authors
- Rautiainen, H., Kärkkäinen, P., Karvonen, A., Nurmi, H., Pikkarainen, P., Nuutinen, H., & Färkkilä, M.
- Affiliations
- Helsinki University Hospital (FI)
- Tampere University Hospital (FI)
- Turku University Hospital (FI)
- Corresponding author
- Rautiainen, Henna
- ORCID
- Färkkilä, Martti
- Venue
- Hepatology
- Published
- 2005-04
- Volume
- 41
- Issue
- 4
- Pages
- 747-752
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2089585697
- Cited by
- 222
- References
- 23
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 6 · 2023: 4 · 2022: 9 · 2021: 6 · 2020: 15 · 2019: 9 · 2018: 11 · 2017: 13 · 2016: 13 · 2015: 18 · 2014: 19 · 2013: 9 · 2012: 11
- FWCI
- 7.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Mary and Georg C Ehrnrooth Foundation
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Keywords
- primary biliary cirrhosis, budesonide, ursodeoxycholic acid, combination therapy, liver histopathology, liver fibrosis, liver inflammation, glucocorticoid adverse effects, serum bilirubin, liver function tests
- MeSH terms
- Adult, Aged, Drug Therapy, Combination, Glucocorticoids, Humans, Liver, Liver Cirrhosis, Liver Cirrhosis, Biliary, Middle Aged, Prospective Studies, Ursodeoxycholic Acid, Budesonide
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