The use of methotrexate, colchicine, and other immunomodulatory drugs in the treatment of primary biliary cirrhosis

Seminars in Liver Disease
M M Kaplan

Abstract

Primary biliary cirrhosis (PBC) is an immunologically mediated disease in which activated T lymphocytes attack and destroy epithelial cells in the small intralobular bile ducts of genetically susceptible patients. This article reviews the results of treatment of PBC with immunomodulatory agents. Results with drugs such as glucocorticoids, azathioprine, and chlorambucil have been disappointing because of either limited efficacy (azathioprine), toxicity (chlorambucil), or both (glucocorticoids). Colchicine improved tests of liver function in three prospective studies and was associated with improved survival for up to 4 years. However, survival benefits were lost at 8 years. Colchicine appears to slow the rate of progression of PBC but not to stop it. Preliminary results suggest that colchicine may have synergistic effects if used together with ursodeoxycholic acid, particularly in patients who are only partially responsive to ursodeoxycholic acid. Results with cyclosporine have been disappointing because of limited efficacy and predictable toxicity. The modest improvement in tests of liver function and survival are counterbalanced by the development of hypertension in some and worsening renal function in most. There is little be...Continue Reading

Citations

Jan 14, 2009·Journal of Ethnobiology and Ethnomedicine·Yibin FengYao Tong
Aug 12, 2014·Digestive Diseases and Sciences·Sonali PaulJatin Roper
Mar 1, 2006·Expert Opinion on Investigational Drugs·Felix Braun, Matthias Behrend
Sep 1, 1999·Rheumatic Diseases Clinics of North America·D VassilopoulosR M Strauss
Jun 2, 2001·Clinics in Liver Disease·R G Gish, A Mason
Feb 5, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·E Anthony Jones
Feb 20, 2003·The American Journal of Gastroenterology·Paolo MuratoriFrancesco B Bianchi
Sep 14, 2012·The Cochrane Database of Systematic Reviews·Wei Xin LiAi Ping Zhang
Aug 10, 2005·The American Journal of Gastroenterology·Yan Gong, Christian Gluud
May 14, 2010·The Cochrane Database of Systematic Reviews·Vanja GiljacaChristian Gluud
Apr 11, 2002·European Journal of Gastroenterology & Hepatology·Amedeo Lonardo, Paola Loria
Apr 24, 2004·The Cochrane Database of Systematic Reviews·Y Gong, C Gluud
Apr 4, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·David ChascsaKeith D Lindor
Jun 1, 2020·Clinica Chimica Acta; International Journal of Clinical Chemistry·Melika LotfiNima Rezaei

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.