Response Rate and Impact on Lipid Profiles of Obeticholic Acid Treatment for Patients with Primary Biliary Cholangitis: A Meta-Analysis
Background. Up to 40% of patients with primary biliary cholangitis (PBC) have an inadequate response to ursodeoxycholic acid (UDCA). Obeticholic acid (OCA) is considered the addition of treatment, but the response rate based on commonly referenced biochemical response criteria and lipids’ impact was...
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Wiley
2021-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2021/8829510 |
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| author | Yuan Gao Li Li Bei Li Yutao Zhan |
| author_facet | Yuan Gao Li Li Bei Li Yutao Zhan |
| author_sort | Yuan Gao |
| collection | DOAJ |
| description | Background. Up to 40% of patients with primary biliary cholangitis (PBC) have an inadequate response to ursodeoxycholic acid (UDCA). Obeticholic acid (OCA) is considered the addition of treatment, but the response rate based on commonly referenced biochemical response criteria and lipids’ impact was unclear. Previous studies reported inconsistency results partially due to small sample size. Therefore, we performed a meta-analysis and aimed to explore OCA treatment’s response rate and effect on lipids’ profiles in PBC patients. Methods. We performed PubMed, Embase, and Cochrane controlled trials register (updated to JUN 2019) databases and manual bibliographical searches for randomized controlled trials reporting on OCA treatment in PBC patients. Two researchers independently extracted data and assessed the risk of bias of studies. We calculated risk ratio (RR) for the overall complete response rate, and the standardized mean difference (SMD) for the serum lipids changes after OCA treatment, all with 95% confidence intervals (CIs) using fixed-effects models. We registered this meta-analysis with PROSPERO (registration number: CRD42020148550). Results. Three trials, with 265 patients, were selected for the analysis. OCA was superior to placebo in PBC patients (RR, 1.48; 95% CI, 1.15–1.90). OCA’s pooled treatment response rate was 65% (95% CI, 56%–74%), corresponding to Paris I criteria. Besides, OCA significantly decreased total cholesterol (P=0.02) with no heterogeneity (P=0.87, I2 = 0%) and high-density lipoprotein levels (P<0.05) with no heterogeneity (P=0.82, I2 = 0%). Conclusions. This meta-analysis demonstrated that OCA was a promising additional treatment for PBC patients and might reduce serum cholesterol levels. The longer follow-up studies are needed to give more evidence. |
| format | Article |
| id | doaj-art-061c304b21f8414396037f9e4829a82d |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-061c304b21f8414396037f9e4829a82d2025-02-03T06:07:40ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972021-01-01202110.1155/2021/88295108829510Response Rate and Impact on Lipid Profiles of Obeticholic Acid Treatment for Patients with Primary Biliary Cholangitis: A Meta-AnalysisYuan Gao0Li Li1Bei Li2Yutao Zhan3Department of Rheumatism Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaDepartment of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaDepartment of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaDepartment of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaBackground. Up to 40% of patients with primary biliary cholangitis (PBC) have an inadequate response to ursodeoxycholic acid (UDCA). Obeticholic acid (OCA) is considered the addition of treatment, but the response rate based on commonly referenced biochemical response criteria and lipids’ impact was unclear. Previous studies reported inconsistency results partially due to small sample size. Therefore, we performed a meta-analysis and aimed to explore OCA treatment’s response rate and effect on lipids’ profiles in PBC patients. Methods. We performed PubMed, Embase, and Cochrane controlled trials register (updated to JUN 2019) databases and manual bibliographical searches for randomized controlled trials reporting on OCA treatment in PBC patients. Two researchers independently extracted data and assessed the risk of bias of studies. We calculated risk ratio (RR) for the overall complete response rate, and the standardized mean difference (SMD) for the serum lipids changes after OCA treatment, all with 95% confidence intervals (CIs) using fixed-effects models. We registered this meta-analysis with PROSPERO (registration number: CRD42020148550). Results. Three trials, with 265 patients, were selected for the analysis. OCA was superior to placebo in PBC patients (RR, 1.48; 95% CI, 1.15–1.90). OCA’s pooled treatment response rate was 65% (95% CI, 56%–74%), corresponding to Paris I criteria. Besides, OCA significantly decreased total cholesterol (P=0.02) with no heterogeneity (P=0.87, I2 = 0%) and high-density lipoprotein levels (P<0.05) with no heterogeneity (P=0.82, I2 = 0%). Conclusions. This meta-analysis demonstrated that OCA was a promising additional treatment for PBC patients and might reduce serum cholesterol levels. The longer follow-up studies are needed to give more evidence.http://dx.doi.org/10.1155/2021/8829510 |
| spellingShingle | Yuan Gao Li Li Bei Li Yutao Zhan Response Rate and Impact on Lipid Profiles of Obeticholic Acid Treatment for Patients with Primary Biliary Cholangitis: A Meta-Analysis Canadian Journal of Gastroenterology and Hepatology |
| title | Response Rate and Impact on Lipid Profiles of Obeticholic Acid Treatment for Patients with Primary Biliary Cholangitis: A Meta-Analysis |
| title_full | Response Rate and Impact on Lipid Profiles of Obeticholic Acid Treatment for Patients with Primary Biliary Cholangitis: A Meta-Analysis |
| title_fullStr | Response Rate and Impact on Lipid Profiles of Obeticholic Acid Treatment for Patients with Primary Biliary Cholangitis: A Meta-Analysis |
| title_full_unstemmed | Response Rate and Impact on Lipid Profiles of Obeticholic Acid Treatment for Patients with Primary Biliary Cholangitis: A Meta-Analysis |
| title_short | Response Rate and Impact on Lipid Profiles of Obeticholic Acid Treatment for Patients with Primary Biliary Cholangitis: A Meta-Analysis |
| title_sort | response rate and impact on lipid profiles of obeticholic acid treatment for patients with primary biliary cholangitis a meta analysis |
| url | http://dx.doi.org/10.1155/2021/8829510 |
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