Management of chronic liver diseases requires treatment of both the underlying liver disease and multiple and often disabling symptoms associated with long-standing cholestasis, including pruritus, metabolic bone disease and malnutrition. Reliable data on the specific treatment are available only for primary biliary cirrhosis and therefore this review will mainly focus on such a disease. With the exception of supplemental therapy with fat soluble vitamins, treatment of the complications of longstanding cholestasis is often unsatisfactory, probably reflecting the poor comprehension of their pathogenesis. Several medical approaches have been proposed attempting to slow or halt progression of primary biliary cirrhosis. Randomized clinical trials have sanctioned penicillamine failure and the efficacy of ursodeoxycholic acid, whereas for several other agents, they have disclosed interesting perspectives, mainly in terms of treatment combinations. However, difficulties have been encountered in assessing long-term benefits of such agents due to the highly variable natural history of primary biliary cirrhosis. In conclusion, ursodeoxycholic acid was shown to delay but not to halt the progression of primary biliary cirrhosis and association therapies with immunosuppressive or antifibrotic agents have been suggested to improve efficacy.
|Translated title of the contribution||Clinical management of chronic cholestatic liver diseases|
|Number of pages||8|
|Publication status||Published - 1997|
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