Pediatric Primary Sclerosing Cholangitis Medication

Updated: Apr 26, 2017
  • Author: Henry C Lin, MD; Chief Editor: Carmen Cuffari, MD  more...
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Medication

Medication Summary

No effective medical therapies are recognized for primary sclerosing cholangitis (PSC). The potential effect of anti-inflammatory and immunosuppressive agents have been studied in adults. Choleretic therapy with ursodiol (ie, ursodeoxycholic acid [UDCA]) has been reported to improve symptoms and biochemical abnormalities, but the long-term effect on clinical outcome remains undetermined. Likewise, the long-term efficacy of immunosuppressive agents and antibiotics remains to be determined.

Overall, the treatment of pediatric primary sclerosing cholangitis remains a significant clinical challenge. Shimizu et al reported successful treatment of a child with primary sclerosing cholangitis and undetermined colitis with a combination of a steroid, salazosulfapyridine, and a probiotic. [61]

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Gallstone Solubilizing Agents

Class Summary

Ursodiol enhances bile salt–dependent biliary flow. It may prove to be a valuable addition to therapy in repeated and refractory cholangitis.

Ursodiol (URSO Forte, Actigall)

Also called ursodeoxycholic acid, or UDCA, choleretic therapy is used to improve bile flow, treat cholestasis, and dissolve gallbladder stones. It has been shown to promote bile flow in cholestatic conditions associated with a patent extrahepatic biliary system.

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