eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
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3/2024
vol. 10
 
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abstract:
Original paper

Ursodeoxycholic acid for the treatment of hepatic sarcoid: A pre-post pilot study

Ethan Weinberg
1
,
Aimee Stonelake
1
,
Kelly Borges
1
,
Emily Toal
1
,
Sevda Aghayeva
1
,
Milton Rossman
2
,
Colin Ligon
3
,
K. Rajender Reddy
1

  1. Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, USA
  2. Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, USA
  3. Division of Rheumatology, University of Pennsylvania, USA
Clin Exp HEPATOL 2024; 10, 3: 194-196
DOI: https://doi.org/10.5114/ceh.2024.141732
Online publish date: 2024/07/25
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Aim of the study:
Sarcoidosis is characterized by noncaseating granulomas that can affect multiple organs. Due to the lack of prospective studies regarding treatment of hepatic sarcoidosis with ursodeoxycholic acid (UDCA), we set out to evaluate its effects in a single-center, open-label, prospective, pre-post study.

Material and methods:
A total of 10 patients were screened from August 2018 to July 2020; seven met the criteria and were enrolled. The study was terminated prior to achieving target enrollment of 10 patients due to the difficulty in recruitment around the COVID-19 pandemic. Most patients were women (4/7; 57.1%) and African American (5/7; 71.4%). One patient dropped out during the first month of observation due to a new diagnosis of esophageal cancer. Six completed the 6-month observation and UDCA treatment periods. One patient stopped UDCA within the first month of active treatment due to the side effect of nausea.

Results:
There was a decrease in ALP and GGT after six months of UDCA treatment compared to six months of observation (ALP – 257.6 to 202.2, p = 0.23; GGT – 302.5 to 111.8, p = 0.059), but this did not reach statistical significance. There were also decreases in all key secondary endpoints (ALT – 50.8 to 29.8, p = NS; AST – 40.3 to 31.2, p = NS, VCTE kPa – 8.3 to 6.3, p = NS). As with the primary endpoints, none of the key secondary endpoints reached statistical significance.

Conclusions:
There is significant potential for UDCA as first-line treatment of hepatic sarcoid. Multi-center, ideally prospective, studies of longer duration are needed.

keywords:

sarcoidosis, hepatic sarcoidosis, ursodeoxycholic acid
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