Ursodeoxycholic Acid (UDCA) in Biliary Diseases: A Clinical Review

Ursodeoxycholic acid (UDCA) is an established and accepted treatment of biliary diseases such as gallstones and primary biliary cirrhosis. Mechanisms of action of UDCA are not so far completely elucidated. UDCA tablets are indicated for the dissolution of small to medium sized radiolucent, cholesterol-rich gall-stones in patients with a functioning gall bladderand in the treatment of primary biliary cirrhosis (PBC). The Food and Drug Administration's Gastrointestinal Drugs Advisory Committee has stated that UDCA is safe and effective for the treatment of primary biliary cirrhosis. More recent Meta-analysis have cast doubt on the real impact of UDCA in patients with PBC. However more recent articles and systematic reviews have pointed out that the risk of death or liver transplantation was reduced by 32% in PBC patients treated with UDCA compared to placebo. In this review we summarized the principal evidence of efficacy of UDCA in the treatment of biliary diseases. UDCA remains so far a relevant pharmacological treatment in biliary diseases.