Display options
Share it on

Gut Liver. 2015 Jul;9(4):547-55. doi: 10.5009/gnl15015.

Efficacy of Magnesium Trihydrate of Ursodeoxycholic Acid and Chenodeoxycholic Acid for Gallstone Dissolution: A Prospective Multicenter Trial.

Gut and liver

Jong Jin Hyun, Hong Sik Lee, Chang Duck Kim, Seok Ho Dong, Seung-Ok Lee, Ji Kon Ryu, Don Haeng Lee, Seok Jeong, Tae Nyeun Kim, Jin Lee, Dong Hee Koh, Eun Taek Park, In-Seok Lee, Byung Moo Yoo, Jin Hong Kim

Affiliations

  1. Department of Internal Medicine, Korea University College of Medicine, Korea.
  2. Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
  3. Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  5. Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
  6. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
  7. Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
  8. Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
  9. Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
  10. Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.

PMID: 26087862 PMCID: PMC4478000 DOI: 10.5009/gnl15015

Abstract

BACKGROUND/AIMS: Cholecystectomy is necessary for the treatment of symptomatic or complicated gallbladder (GB) stones, but oral litholysis with bile acids is an attractive alternative therapeutic option for asymptomatic or mildly symptomatic patients. This study was conducted to evaluate the efficacy of magnesium trihydrate of ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) on gallstone dissolution and to investigate improvements in gallstone-related symptoms.

METHODS: A prospective, multicenter, phase 4 clinical study to determine the efficacy of orally administered magnesium trihydrate of UDCA and CDCA was performed from January 2011 to June 2013. The inclusion criteria were GB stone diameter ≤15 mm, GB ejection fraction ≥50%, radiolucency on plain X-ray, and asymptomatic/mildly symptomatic patients. The patients were prescribed one capsule of magnesium trihydrate of UDCA and CDCA at breakfast and two capsules at bedtime for 6 months. The dissolution rate, response rate, and change in symptom score were evaluated.

RESULTS: A total of 237 subjects were enrolled, and 195 subjects completed the treatment. The dissolution rate was 45.1% and the response rate was 47.2% (92/195) after 6 months of administration of magnesium trihydrate of UDCA and CDCA. Only the stone diameter was significantly associated with the response rate. Both the symptom score and the number of patients with symptoms significantly decreased regardless of stone dissolution. Adverse events necessitating discontinuation of the drug, surgery, or endoscopic management occurred in 2.5% (6/237) of patients.

CONCLUSIONS: Magnesium trihydrate of UDCA and CDCA is a well-tolerated bile acid that showed similar efficacy for gallstone dissolution and improvement of gallstone-related symptoms as that shown in previous studies.

Keywords: Chenodeoxycholic acid; Dissolution; Gallstones; Ursodeoxycholic acid

References

  1. Lancet. 1981 Dec 5;2(8258):1296 - PubMed
  2. Am J Gastroenterol. 2003 Dec;98(12):2605-11 - PubMed
  3. J Med Invest. 1998 Aug;45(1-4):115-22 - PubMed
  4. Lancet. 2006 Jul 15;368(9531):230-9 - PubMed
  5. Digestion. 1981;22(4):185-91 - PubMed
  6. Lancet. 1972 Dec 9;2(7789):1213-6 - PubMed
  7. Gastroenterology. 1975 Jun;68(6):1563-6 - PubMed
  8. Korean J Gastroenterol. 2012 Jan;59(1):27-34 - PubMed
  9. Gut. 1992 Mar;33(3):381-6 - PubMed
  10. Br Med J (Clin Res Ed). 1981 Sep 5;283(6292):645-6 - PubMed
  11. Gastroenterology. 1989 Jan;96(1):222-9 - PubMed
  12. Gut Liver. 2013 Nov;7(6):719-24 - PubMed
  13. Gastroenterology. 1986 Sep;91(3):713-8 - PubMed
  14. Aliment Pharmacol Ther. 1993 Apr;7(2):139-48 - PubMed
  15. Aliment Pharmacol Ther. 2001 Jan;15(1):123-8 - PubMed
  16. Gastroenterology. 1988 Oct;95(4):1029-35 - PubMed
  17. Gut. 1975 May;16(5):359-64 - PubMed
  18. Gastrointest Radiol. 1990 Winter;15(1):58-60 - PubMed
  19. Ann Intern Med. 1982 Sep;97(3):351-6 - PubMed
  20. Dig Dis Sci. 1999 Aug;44(8):1674-83 - PubMed
  21. Gastroenterol Res Pract. 2012;2012:159438 - PubMed
  22. Lancet. 1977 Aug 20;2(8034):367-9 - PubMed
  23. AJR Am J Roentgenol. 1988 Dec;151(6):1123-8 - PubMed
  24. Dig Dis Sci. 1982 Nov;27(11):1025-9 - PubMed
  25. World J Gastrointest Pharmacol Ther. 2012 Apr 6;3(2):7-20 - PubMed
  26. Gastroenterol Clin North Am. 1991 Mar;20(1):1-19 - PubMed
  27. Gut. 1980 Dec;21(12):1077-81 - PubMed
  28. N Engl J Med. 1972 Jan 6;286(1):1-8 - PubMed
  29. Hepatology. 2013 Dec;58(6):2133-41 - PubMed
  30. J Dig Dis. 2013 Oct;14(10):559-63 - PubMed
  31. Gut. 2007 Jun;56(6):815-20 - PubMed
  32. Gut. 1982 May;23(5):382-9 - PubMed

Substances

MeSH terms

Publication Types