In patients with PBC, effectiveness of UDCA with Vit D combination and its impact on hepatic fibrosis

<h2 id="objectives">Objectives</h2><ul><li>To evaluate whether vitamin D (VitD) supplementation improves ursodeoxycholic acid (UDCA) treatment outcomes in primary biliary cholangitis(PBC) patients, particularly regarding hepatic fibrosis reduction.</li></ul><h2 id="methods">Methods</h2><ul><li>Study Design: Prospective randomized controlled trial</li><li>Participants: 60treatment-naive PBC patients</li><li>Setting: Infectious Diseases Department and outpatient clinic</li><li><strong>Treatment Protocol:</strong><ul><li>Year 1: Patients randomized into two groups<ul><li>UDCA+VitD group (n=30): UDCA + VitD 1200IU/day</li><li>UDCA monotherapy group (n=30): UDCA alone</li></ul></li><li><strong>Year2:</strong> UDCA monotherapy group re-randomized for validation</li></ul></li><li><strong>Endpoints:</strong> Biochemical response (Paris I and Barcelona criteria), liver stiffness</li><li>measurement (LSM) via FibroTouch, and symptom assessment using PBC-40 questionnaire.</li></ul><h2 id="results">Results</h2><ul><li>Biochemical response evaluation using established PBC treatment efficacy criteria has been shown in Table 1.</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/Treatment%20Response%20Rates.webp" alt="Treatment Response Rates" width="1126" height="382"></p><h3>Biochemical improvements(UDCA+VitD vs UDCA)</h3><ul><li>Aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), total bilirubin (Tbil), prothrombin time (PT), international normalized ratio (INR), immunoglobulin M (IgM): significantly decreased (P&lt;0.05)</li><li>Albumin (ALB), 25-hydroxyvitamin D [25(OH)D] levels: significantly increased (P&lt;0.05)</li><li>Liver stiffness measurement(LSM): 11.04+4.46 vs 15.32+6.19 kPa, indicating reduced hepatic fibrosis in combination therapy group (P&lt;0.05)</li></ul><h2 id="clinical-benefits">Clinical Benefits</h2><ul><li>Greater symptom improvement (fatigue, itch, sicca symptoms)</li><li>Negative correlation between 25(OH)D and LSM levels (r=-0.5607, P&lt;0.0001)</li><li>Sustained benefits maintained through extended treatment period</li></ul><h2 id="conclusion" data-section="conclusion">Conclusion</h2><ul><li>UDCA+VitD combination therapy significally improves treatment response rates, liver function parameters, and hepatic fibrosis compared to UDCA monotherapy</li><li>VitD supplementation may serve as an effective adjunctive therapy in PBC management, potentially through immunodulatory and antifibrotic mechanisms</li></ul>

Gastro Update 2025   Issue 5

<ul><li><a href="#objectives">Objectives</a></li><li><a href="#methods">Methods</a></li><li><a href="#results">Results</a></li><li><a href="#clinical-benefits">Clinical Benefits</a></li><li><a href="#conclusion">Conclusion</a></li></ul><p>&nbsp;</p>

In patients with PBC, effectiveness of UDCA with Vit D combination and its impact on hepatic fibrosis

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