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Most past approaches to primary biliary cirrhosis (PBC) have employed immunosuppressive agents. These treatments are beneficial but are difficult to give on a long-term basis because of side effects.
A French team speculated that the retention of bile acids in the inflamed bile ducts, while a secondary event, nevertheless might add to the inflammatory process and compound the hepatic damage. They therefore attempted to reduce bile acid levels in the bile ducts with ursodiol, in a randomized trial of 146 patients with biopsy-proven PBC.
Treatment failure (defined as a doubling of bilirubin levels, severe complications, or adverse side effects) occurred in 8 percent of the treated patients, versus 18 percent of those not treated. Ursodiol was a…