Robles-Díaz, MercedesNezic, LanaVujic-Aleksic, VesnaBjörnsson, Einar S.2022-12-122022-12-122021-10-27Robles-Díaz M, Nezic L, Vujic-Aleksic V, Björnsson ES. Role of Ursodeoxycholic Acid in Treating and Preventing Idiosyncratic Drug-Induced Liver Injury. A Systematic Review. Front Pharmacol. 2021 Oct 27;12:744488http://hdl.handle.net/10668/4485Introduction: Treatment is generally not available for drug-induced liver injury (DILI) patients except in some specific circumstances. The management of DILI is based on the withdrawal of the responsible drug and monitoring the patients and only a few patients need to be referred to a transplant center. Some studies on the role of ursodeoxycholic acid (UDCA) in DILI have been published. The aim of this study was to perform a systematic review of the role of UDCA in the treatment and prevention of DILI. Methods: A search was undertaken in PubMed, with the key words ursodeoxycholic acid, drug-induced liver injury and hepatotoxicity following the PRISMA guidelines. Results: A total of 33 publications were identified: 25 case reports and 8 case series. In 18 of the 25 cases reports (22 patients), authors reported improvement of liver injury associated with UDCA therapy whereas 7 case reports did not show clinical or biochemical improvement after UDCA treatment. There were 4 studies evaluating the role of UDCA in the treatment of DILI, three prospective (one being a clinical trial) and one retrospective studies. Three studies observed liver profile improvements associated with UDCA. In addition, four studies evaluated UDCA in the prevention of DILI: one pilot study, two randomized clinical trials (RCT) and one retrospective study. Three of these studies observed a lower percentage of patients with an increase in transaminases in the groups that used UDCA for DILI prevention. Conclusion: According to available data UDCA seems to have some benefits in the treatment and prevention of DILI. However, the design of the published studies does not allow a firm conclusion to be drawn on the efficacy of UDCA in DILI. A well designed RCT to evaluate the role of UDCA in DILI is needed.enAtribución 4.0 InternacionalAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/http://creativecommons.org/licenses/by/4.0/Ursodeoxycholic acidDrug-induced liver injuryHepatotoxicityTreatmentPreventionPilot studyPubMedÁcido ursodesoxicólicoEnfermedad hepática inducida por sustancias y drogasTerapéuticaPrevención de enfermedadesProyectos pilotoMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Bile Acids and Salts::Cholic Acids::Deoxycholic Acid::Ursodeoxycholic AcidMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective StudiesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Pilot ProjectsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective StudiesMedical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Transferases::Nitrogenous Group Transferases::TransaminasesMedical Subject Headings::Information Science::Information Science::Information Storage and Retrieval::Databases as Topic::Databases, Bibliographic::PubMedMedical Subject Headings::Diseases::Chemically-Induced Disorders::Drug-Related Side Effects and Adverse Reactions::Drug-Induced Liver InjuryMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::TherapeuticsMedical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Bile Acids and Salts::Cholic Acids::Deoxycholic Acid::Ursodeoxycholic AcidMedical Subject Headings::Diseases::Chemically-Induced Disorders::Drug-Related Side Effects and Adverse Reactions::Drug-Induced Liver Injuryreview article34776963open access10.3389/fphar.2021.7444881663-9812PMC8578816