LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 150

Search options

  1. Article: Practical management of primary biliary cholangitis.

    Parés, Albert

    Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

    2021  Volume 114, Issue 7, Page(s) 410–417

    Abstract: Primary biliary cholangitis (PBC) is a chronic and cholestatic liver disease of autoimmune pathogenesis that mainly affects middle-aged women. Patients show elevated alkaline phosphatase and bilirubin levels as the disease progresses. The main symptoms ... ...

    Abstract Primary biliary cholangitis (PBC) is a chronic and cholestatic liver disease of autoimmune pathogenesis that mainly affects middle-aged women. Patients show elevated alkaline phosphatase and bilirubin levels as the disease progresses. The main symptoms of the disease are pruritus and fatigue, which interfere with the quality of life of patients. Progressive damage leading to end stage liver disease could require liver transplantation. Despite the efficacy of ursodeoxycholic acid (UDCA), the current standard of care for PBC, up to 40% of patients have an inadequate response to the treatment, requiring a second-line therapy. Obeticholic acid is the only second-line treatment approved for PBC in combination with UDCA in adults with an inadequate response to UDCA, or as monotherapy in patients intolerant to UDCA. Although different clinical guidelines for the diagnosis and management of PBC have been published, PBC is still challenging for many physicians. In this article we briefly review the main characteristics of the disease and include a practical user-friendly algorithm for the diagnosis and management of PBC developed by Spanish PBC experts and based on the European Association for the Study of the Liver recommendations.
    MeSH term(s) Adult ; Cholangitis/drug therapy ; Cholangitis/therapy ; End Stage Liver Disease ; Female ; Humans ; Liver Cirrhosis, Biliary/complications ; Liver Cirrhosis, Biliary/diagnosis ; Liver Cirrhosis, Biliary/therapy ; Middle Aged ; Quality of Life ; Ursodeoxycholic Acid/therapeutic use
    Chemical Substances Ursodeoxycholic Acid (724L30Y2QR)
    Language English
    Publishing date 2021-10-18
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 1070381-0
    ISSN 1130-0108 ; 0212-7512
    ISSN 1130-0108 ; 0212-7512
    DOI 10.17235/reed.2021.8219/2021
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article ; Online: Bone fractures in primary biliary cholangitis.

    Parés, Albert / Guañabens, Núria

    Journal of internal medicine

    2023  Volume 294, Issue 2, Page(s) 159–160

    MeSH term(s) Humans ; Liver Cirrhosis, Biliary/complications ; Fractures, Bone/complications
    Language English
    Publishing date 2023-05-10
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 96274-0
    ISSN 1365-2796 ; 0954-6820
    ISSN (online) 1365-2796
    ISSN 0954-6820
    DOI 10.1111/joim.13644
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: Primary biliary cholangitis.

    Parés, Albert

    Medicina clinica

    2018  Volume 151, Issue 6, Page(s) 242–249

    Abstract: Primary cholangitis (cirrhosis) is a chronic cholestatic disease with an unquestionable female predominance. It is characterised by inflammation of the small and medium size bile ducts, and can eventually progress to cirrhosis. Most patients remain ... ...

    Title translation Colangitis biliar primaria.
    Abstract Primary cholangitis (cirrhosis) is a chronic cholestatic disease with an unquestionable female predominance. It is characterised by inflammation of the small and medium size bile ducts, and can eventually progress to cirrhosis. Most patients remain asymptomatic and are diagnosed by the casual finding of an anicteric biochemical cholestasis with increased alkaline phosphatase. The pathogenesis is unknown and of presumed autoimmune origin in genetic susceptible subjects. M2-type antimitochondrial antibodies, and specific antinuclear antibodies (gp210 and Sp100) are typical and specific of the disease. The positivity of these antibodies and a biochemical cholestasis are sufficient for diagnosis, without the need for liver biopsy. Ursodeoxycholic acid is the specific treatment with an excellent response in more than 60% of patients. When this optimal response is not observed, it can be combined with new agents, but those that have shown to be effective are those that improve cholestasis such as fibrates and obeticholic acid.
    MeSH term(s) Humans ; Liver Cirrhosis, Biliary/diagnosis ; Liver Cirrhosis, Biliary/therapy
    Language Spanish
    Publishing date 2018-03-09
    Publishing country Spain
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2017.12.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Juan Rodés. A successful and extraordinary life of a visionary hepatologist.

    Pares, Albert

    Gut

    2017  Volume 66, Issue 4, Page(s) 736

    MeSH term(s) Gastroenterology/history ; History, 20th Century ; History, 21st Century ; Spain
    Language English
    Publishing date 2017-03-08
    Publishing country England
    Document type Biography ; Historical Article ; Journal Article ; Portrait
    ZDB-ID 80128-8
    ISSN 1468-3288 ; 0017-5749
    ISSN (online) 1468-3288
    ISSN 0017-5749
    DOI 10.1136/gutjnl-2016-313950
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article ; Online: Novel Treatment Strategies for Primary Biliary Cholangitis.

    Parés, Albert

    Seminars in liver disease

    2017  Volume 37, Issue 1, Page(s) 60–72

    Abstract: Despite the presumed immunological pathogenesis of primary biliary cholangitis, no clear or even harmful consequences have resulted from treatments designed to modify the immunological condition. Ursodeoxycholic acid (13-16 mg/kg/d) has, however, clear ... ...

    Abstract Despite the presumed immunological pathogenesis of primary biliary cholangitis, no clear or even harmful consequences have resulted from treatments designed to modify the immunological condition. Ursodeoxycholic acid (13-16 mg/kg/d) has, however, clear favorable effects that not only improve biochemical cholestasis, but also delay histological progression. Long-term treatment with ursodeoxycholic acid is associated with excellent transplant-free survival in cases showing a biochemical response at 1 year. Data on the effects of obeticholic acid and fibrates are encouraging. Moreover, recent pilot studies evaluating several biological agents targeting immunity such as different monoclonal antibodies and other drugs that modulate cholestasis are under investigation, although with limited results at present.
    Language English
    Publishing date 2017-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603177-8
    ISSN 1098-8971 ; 0272-8087
    ISSN (online) 1098-8971
    ISSN 0272-8087
    DOI 10.1055/s-0036-1597929
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: An appealing new agent for treating cholestatic pruritus.

    Parés, Albert

    Lancet (London, England)

    2017  Volume 389, Issue 10074, Page(s) 1078–1080

    Language English
    Publishing date 2017-03-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(17)30320-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article ; Online: Juan Rodés. A successful and extraordinary life of a visionary hepatologist.

    Pares, Albert

    Gut

    2017  

    Language English
    Publishing date 2017-02-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 80128-8
    ISSN 1468-3288 ; 0017-5749
    ISSN (online) 1468-3288
    ISSN 0017-5749
    DOI 10.1136/gutjnl-2017-313950
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article ; Online: Therapy of Primary Biliary Cirrhosis: Novel Approaches for Patients with Suboptimal Response to Ursodeoxycholic Acid.

    Parés, Albert

    Digestive diseases (Basel, Switzerland)

    2015  Volume 33 Suppl 2, Page(s) 125–133

    Abstract: Primary biliary cirrhosis (PBC) is a chronic cholestatic disease of presumed autoimmune pathogenesis, characterized by the inflammation and damage of the intrahepatic intermediate and small bile ducts, which eventually results in cirrhosis. A number of ... ...

    Abstract Primary biliary cirrhosis (PBC) is a chronic cholestatic disease of presumed autoimmune pathogenesis, characterized by the inflammation and damage of the intrahepatic intermediate and small bile ducts, which eventually results in cirrhosis. A number of randomized and observational and pilot studies using several agents were carried out in the 80s, but no clear results or even harmful effects were reported. Over the past 2 decades, increasing evidence indicates that ursodeoxycholic acid (UDCA) - 13 to 16 mg/kg/day--is the treatment of choice for patients with PBC. Biochemical response to UDCA, assessed at 1 year, clearly predicts the long-term outcome, since in UDCA, responders survival is similar to that estimated for the matched control population. However, about 40% of patients have incomplete biochemical response and increased risk of progression and decreased survival free of transplantation. Patients with suboptimal biochemical response to UDCA outline the group in whom further single or combined treatments with UDCA are needed. Accordingly, data on the effect of fibrates alone or in combination with UDCA, and budesonide in combination with UDCA have been reported. The combined treatment of UDCA and fibrates in patients without optimal biochemical response to UDCA improves the degree of cholestasis and may minimize the long-term management of these patients. The results of the combined therapy of UDCA with budesonide are appealing but they should be established in large randomized trials. The effect of new agents such obeticholic acid are promising, since the addition of this farnesoide-X-receptor agonist bile acid in patients with stable UDCA dosage and increased alkaline phosphatase levels results in an improvement of cholestasis as compared to placebo, with a parallel decrease of aminotransferases and immunoglobulin M, as well as one surrogate marker of bile acid synthesis. New molecular therapies are currently being investigated.
    MeSH term(s) Antibodies, Monoclonal/therapeutic use ; Chenodeoxycholic Acid/analogs & derivatives ; Chenodeoxycholic Acid/therapeutic use ; Cholagogues and Choleretics/therapeutic use ; Fibric Acids/therapeutic use ; Glucocorticoids/therapeutic use ; Humans ; Liver Cirrhosis, Biliary/drug therapy ; Treatment Failure ; Treatment Outcome ; Ursodeoxycholic Acid/therapeutic use
    Chemical Substances Antibodies, Monoclonal ; Cholagogues and Choleretics ; Fibric Acids ; Glucocorticoids ; Chenodeoxycholic Acid (0GEI24LG0J) ; Ursodeoxycholic Acid (724L30Y2QR)
    Language English
    Publishing date 2015
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 632798-9
    ISSN 1421-9875 ; 0257-2753
    ISSN (online) 1421-9875
    ISSN 0257-2753
    DOI 10.1159/000440761
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: Old and novel therapies for primary biliary cirrhosis.

    Parés, Albert

    Seminars in liver disease

    2014  Volume 34, Issue 3, Page(s) 341–351

    Abstract: Despite the presumed immunological pathogenesis of primary biliary cirrhosis, no clear or even harmful consequences resulted from some specific treatments addressed to modify the immunological condition. However, ursodeoxycholic acid (UDCA; 13-16 mg/kg/d) ...

    Abstract Despite the presumed immunological pathogenesis of primary biliary cirrhosis, no clear or even harmful consequences resulted from some specific treatments addressed to modify the immunological condition. However, ursodeoxycholic acid (UDCA; 13-16 mg/kg/d) has clear favorable effects not only by improving biochemical cholestasis, but also by delaying the histological progression. Long -term treatment with UDCA is associated with excellent survival, free of transplantation in cases showing biochemical response at one year. In the remaining patients, data on the effect of fibrates, budesonide, or obeticholic acid are encouraging. Pruritus is usually managed using resins; further steps are needed in resistant cases with the use of rifampicin, naltrexone, sertraline, or invasive procedures such as albumin dialysis. Osteoporosis, which is highly prevalent in patients with deep and prolonged cholestasis, improves with bisphosphonates; current data indicate that both weekly alendronate and monthly ibandronate increase bone mass in patients with osteoporosis. Nutritional and fat-vitamin supplementation is also mandatory in patients with severe cholestasis.
    MeSH term(s) Anti-Inflammatory Agents/therapeutic use ; Antipruritics/therapeutic use ; Bile Ducts, Intrahepatic/drug effects ; Bile Ducts, Intrahepatic/immunology ; Bile Ducts, Intrahepatic/pathology ; Bone Density Conservation Agents/therapeutic use ; Cholagogues and Choleretics/therapeutic use ; Dietary Supplements ; Drug Therapy, Combination ; Gastrointestinal Agents/adverse effects ; Gastrointestinal Agents/therapeutic use ; Humans ; Liver Cirrhosis, Biliary/complications ; Liver Cirrhosis, Biliary/diagnosis ; Liver Cirrhosis, Biliary/drug therapy ; Liver Cirrhosis, Biliary/immunology ; Liver Transplantation ; Osteoporosis/drug therapy ; Osteoporosis/etiology ; Pruritus/drug therapy ; Pruritus/etiology ; Treatment Outcome ; Ursodeoxycholic Acid/therapeutic use
    Chemical Substances Anti-Inflammatory Agents ; Antipruritics ; Bone Density Conservation Agents ; Cholagogues and Choleretics ; Gastrointestinal Agents ; Ursodeoxycholic Acid (724L30Y2QR)
    Language English
    Publishing date 2014-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 603177-8
    ISSN 1098-8971 ; 0272-8087
    ISSN (online) 1098-8971
    ISSN 0272-8087
    DOI 10.1055/s-0034-1383733
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article: Treatment of primary biliary cirrhosis: Is there more to offer than ursodeoxycholic acid?

    Parés, Albert

    Clinical liver disease

    2014  Volume 3, Issue 2, Page(s) 29–33

    Language English
    Publishing date 2014-03-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2657644-2
    ISSN 2046-2484
    ISSN 2046-2484
    DOI 10.1002/cld.311
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top