Expert Consensus on the Use of UDCA in the Management

Expert Consensus on the Use of UDCA in the Management of Liver Disorders

<h2 id="background">Background</h2><ul><li>Ursodeoxycholic acid (UDCA) is a hydrophilic bile acid with well-established therapeutic benefits in several liver disorders.</li><li>It is the first-line treatment for primary biliary cholangitis (PBC), where it improves liver biochemistry, slows disease progression, and enhances survival.</li><li>UDCA is also used for cholesterol gallstone dissolution and has shown benefits in metabolic dysfunction-associated fatty liver disease (MAFLD) by improving hepatic steatosis and normalizing liver enzymes.</li></ul><h2 id="objective">Objective</h2><ul><li>This study aimed to assess expert opinions on the use of UDCA in the management of liver disorders in routine clinical practice.</li></ul><h2 id="methods">Methods</h2><ul><li>Cross-sectional survey conducted using a 22-item, multiple-response questionnaire designed to capture expert perspectives on diagnosis, disease spectrum, therapeutic indications, dosing preferences, and clinical experience with UDCA.</li><li>A total of 519 clinicians participated in the study.</li><li>The survey included specialists actively involved in managing liver diseases. Data were analyzed using descriptive statistics.</li></ul><h2 id="results">Results</h2><ul><li>Approximately 53% identified MAFLD as the most commonly encountered liver disorder (Table 1).&nbsp;</li></ul><figure class="image"><img style="aspect-ratio:1111/180;" src="https://cdn.megawecare.com/GHBY/Internal-Images/distribution-of-responses-to%20most-common-liver-disease.webp" alt="Distribution of responses to the most common liver disease in routine pratice" width="1111" height="180"></figure><ul><li>According to 79% of respondents, the key benefits of UDCA include inhibition of bile acid synthesis, reduced intestinal cholesterol absorption, protection of cholangiocytes from toxic bile acids, and stimulation of hepatocellular regeneration (Table 2).</li></ul><figure class="image"><img style="aspect-ratio:1162/255;" src="https://cdn.megawecare.com/GHBY/Internal-Images/distribution-of-responses-on-advantages-of-udca-in%20liver-disease.webp" alt="Distribution of responses on the advantages of UDCA in the management of liver diseases" width="1162" height="255"></figure><figure class="image"><img style="aspect-ratio:1143/574;" src="https://cdn.megawecare.com/GHBY/Internal-Images/liver-and-udca.webp" width="1143" height="574"></figure><figure class="image"><img style="aspect-ratio:1159/406;" src="https://cdn.megawecare.com/GHBY/Internal-Images/chronic-cholestatic-liver-diseases.webp" width="1159" height="406"></figure><h2 id="conclusion" data-section="conclusion">Conclusion</h2><ul><li>This study highlights a strong consensus among clinicians regarding the broad clinical utility of UDCA in liver disorders, especially MAFLD and chronic cholestatic diseases such as PBC.</li><li>UDCA twice daily emerged as the preferred dosing regimen.</li><li>Clinicians consistently recognized its role in improving liver biochemistry, slowing disease progression, and enhancing liver histology in real-world practice.</li></ul>

Gastro Update   Issue 1   Jan 2026

<ul><li><a href="#background">Background</a></li><li><a href="#objective">Objective</a></li><li><a href="#methods">Methods</a></li><li><a href="#results">Results</a></li><li><a href="#conclusion">Conclusion</a></li></ul>

Expert Consensus on the Use of UDCA in the Management of Liver Disorders

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