The Efficacy And Safety Of Ursodesoxycholic Acid In The Treatment Of Nonalcoholic Fatty Liver Disease: A Meta-analysis

Aim: The aim of this study was to evaluate the efficacy and safety of ursodesoxycholic acid(UDCA)alone or combined with other drugs for nonalcoholic fatty liver disease(NAFLD).Method: This meta-analysis only included randomized controlled trials(RCT)on UDCA in the treatment of nonalcoholic fatty liver disease.The electronic databases,including Pub Med,Embase,Cochrane Library,Wiley Online Library and EBSCO+MEDLINE,were searched.Rev Man5.3 was used to analysis data.Result: A total of 10 studies involving 1109 patients were included,512 in UDCA arm(UDCA alone or combined with other drugs),and 597 in control arm(placebo or other drugs).The follow-up time ranged from 6 weeks to 24 months.UDCA had significantly improved GGT[WMD=-16.52,95%CI(-31.28,-1.77),P=0.03].However,no significant difference was found between UDCA treatment and control treatment in the following indicators: AST[WMD=-6.98,95%CI(-15.71,1.75),P=0.12],ALT[WMD=-2.16,95%CI(-7.19,2.87),P=0.40],ALP[WMD=-0.68,95%CI(-11.39,10.02),P=0.90],TCHOL[WMD=4.53,95%CI(-2.97,12.04),P=0.24],TG[WMD=0.95,95%CI(4.02,2.13),P=0.55],BMI [WMD=-0.28,95%CI(-0.79,0.23),P=0.29],liver density [WMD=-0.15,95%CI(-0.40,0.09),P=0.23],ultrasound score[WMD=0.12,95%CI(-0.31,0.54),P=0.59],Modified Brunt score(Steatosis [WMD=-0.06,95%CI(-0.21,0.09),P=0.43],Ballooning [WMD=0.02,95%CI(-0.17,0.20),P=0.87],Lobular inflammation[WMD=-0.10,95%CI(-0.41,0.22),P=0.55],Fibrosis [WMD= 0.00,95%CI(-0.23,0.24),P=0.97],Mallory’s hyaline [WMD= 0.10,95%CI(-0.18,0.38),P=0.49]).UDCA had significantly higher incidence of diarrhea[RR= 2.97,95%CI(1.67,5.28),P=0.0002].There was no statistically significant difference in the incidence of abdominal pain[RR=1.58,95%CI(0.84,2.95),P=0.15],nausea[RR= 2.94,95%CI(0.31,27.50),P=0.34],and total adverse reactions [RR=1.79,95%CI(0.95,3.38),P=0.07].Conclusion: UDCA is safe in the management of NAFLD,however,it shows no substantial positive effect than control.