A meta-analysis of ursodeoxycholic acid therapy versus combination therapy with corticosteroids for PBC-AIH-overlap syndrome: evidence from 97 monotherapy and 117 combinations
Open accessAbstract
In this study, a meta-analysis of randomised controlled trials that compared ursodeoxycholic acid (UDCA) monotherapy with therapies combining UDCA and corticosteroids was performed. We found that combination therapy with UDCA and corticosteroids was more effective than UDCA monotherapy for primary biliary cirrhosis-autoimmune hepatitis-overlap syndrome.
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Meta-analysis of existing bezafibrate randomised clinical trials shows no significant improvement in patient survival compared with UDCA monotherapy, although liver transplantation and liver-related death were not presented as clinical endpoints.
“As such, meta-analysis of existing bezafibrate randomised clinical trials show no significant improvement in patient survival compared with UDCA monotherapy,170 although liver transplantation and liver-related death were not presented as clinical endpoints.”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [170]
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Experimental — accuracy not yet measuredBudesonide in combination with UDCA improves survival in comparison to UDCA monotherapy and is associated with fewer side effects than other immunosuppressive regimes.
“There is evidence to support the use of budesonide in combination with UDCA, an approach which improves survival in comparison to UDCA monotherapy and is associated with fewer side effects than other immunosuppressive regimes.170”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [170]
The Discussion (page unavailable) says UDCA plus corticosteroids did not significantly improve mortality or death/liver transplantation compared with UDCA alone, contrary to the claimed survival benefit. It mentions budesonide only as a possible alternative treatment; the analysis does not establish a survival benefit for UDCA plus budesonide or compare its side effects with other immunosuppressive regimens. (LLM, conf=0.89)
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Experimental — accuracy not yet measuredMeta-analysis supports the use of combination of immunosuppressive therapy and UDCA in patients with true overlap.
“Meta-analysis supports the use of combination of immunosuppressive therapy and UDCA in patients with true overlap, but the challenges of disease classification impact directly on the value of such meta-analyses per se.170”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [170]
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- Authors
- Zhang, H., Li, S., Yang, J., Zheng, Y., Wang, J., Lu, W., Zhou, Y., Yin, Q., Zhu, R., & Guo, C.
- Affiliations
- Tongji University (CN)
- Corresponding author
- Guo, Chuanyong
- ORCID
- Venue
- Gastroenterology Review
- Publisher
- Termedia Sp. z.o.o.
- Published
- 2015
- Volume
- 3
- Issue
- 3
- Pages
- 148-155
- ISSN
- 1895-5770 (ISSN-L)
- PMC
- PMC4607695
- OpenAlex
- W1951557360
- Cited by
- 17
- References
- 35
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 2 · 2019: 1 · 2018: 3 · 2017: 2
- FWCI
- 0.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Gastroenterology Review (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Science Foundation
- National Natural Science Foundation of China (81270515)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Keywords
- ursodeoxycholic acid, corticosteroids, combination therapy, primary biliary cirrhosis, autoimmune hepatitis, PBC-AIH overlap syndrome, monotherapy, treatment efficacy
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