Rifampicin in the treatment of severe intrahepatic cholestasis of pregnancy
Abstract
Objective To describe the use of combined ursodeoxycholic acid (UDCA) and rifampicin treatment in intrahepatic cholestasis of pregnancy (ICP). Study design A questionnaire survey of 27 women with 28 affected pregnancies identified via the UK and International Obstetric Medicine forum. The clinical case notes of women with ICP treated with combined UDCA and rifampicin therapy were reviewed, and data regarding maternal and perinatal outcomes extracted. Results Serum bile acids remained high whilst taking UDCA as monotherapy. In 14 pregnancies (54%) serum bile acids decreased following the introduction of rifampicin. In 10 pregnancies (38%), there was a 50% reduction in serum bile acids. There were no adverse effects reported with either drug. Conclusions This is the first report of the use of rifampicin in ICP. The data suggest that combined treatment with UDCA and rifampicin is an effective way of treating women with severe ICP who do not respond to treatment with UDCA alone.
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Cholestyramine and rifampicin (second trimester onwards) are considered safe in pregnancy, although the data are limited.
“Additionally, cholestyramine and rifampicin (second trimester onwards) are considered safe in pregnancy, although the data are limited.155 278”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [278]
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Ursodeoxycholic acid in pregnancy?
de Vries, E., & Beuers, U. (2019) · Journal of Hepatology · doi:10.1016/j.jhep.2019.08.020 · Cited by 40 · see citing works
- Authors
- Geenes, V., Chambers, J., Khurana, R., Shemer, E. W., Sia, W., Mandair, D., Elias, E., Marschall, H.-U., Hague, W., & Williamson, C.
- Affiliations
- King's College London (GB)
- Imperial College London (GB)
- University of Alberta (CA)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- University of Gothenburg (SE)
- The University of Adelaide (AU)
- Corresponding author
- Williamson, Catherine
- ORCID
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 2015-06
- Volume
- 189
- Pages
- 59-63
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- OpenAlex
- W2109866339
- Cited by
- 98
- References
- 5
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 3 · 2022: 13 · 2021: 13 · 2020: 12 · 2019: 10 · 2018: 11 · 2017: 5 · 2016: 7 · 2015: 6
- FWCI
- 10.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- intrahepatic cholestasis of pregnancy, rifampicin, ursodeoxycholic acid, serum bile acids, treatment response, maternal outcomes, perinatal outcomes, adverse drug reactions
- MeSH terms
- Bile Acids and Salts, Cholestasis, Intrahepatic, Drug Therapy, Combination, Female, Gestational Age, Humans, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Rifampin, Ursodeoxycholic Acid
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