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In recent studies, ursodeoxycholic acid (UDCA) did not improve survival in patients with primary sclerosing cholangitis (PSC), and high-dose UDCA (28–30 mg/kg/day) was associated with a twofold increase in adverse events (NEJM JW Gastroenterol Oct 23 2009). Because of these data, most clinicians are discontinuing UDCA in their PSC patients. The consequences of stopping UDCA in this group are unknown. These researchers prospectively followed 26 PSC patients on a stable dose of UDCA (10–15 mg/kg/day) before they began withdrawal of the drug. Laboratory values were assessed at baseline and at 3 months after UDCA was stopped, as were health-related quality of life and pruritus via questionnaires.
After withdrawal of UDCA, 21 of 26 patients devel…