Consilium Medicum (Feb 2023)

Therapeutic efficacy evaluation of the reference drug ursodeoxycholic acid and its analogues in the biliary sludge dissolution: a meta-analysis

  • Yury A. Kucheryavyy,
  • Sergei V. Cheremushkin

DOI
https://doi.org/10.26442/20751753.2022.12.201429
Journal volume & issue
Vol. 24, no. 12
pp. 860 – 864

Abstract

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Aim. To compare the therapeutic efficacy of the reference drug ursodoxycholic acid (UDCA) for Russian Federation (Ursofalk) and generic UDCA preparations of other manufacturers in the solution of biliary sludge (BS). Materials and methods. The search for studies was carried out in the electronic databases MEDLINE/PubMed, EMBASE, Cochrane, Russian Science Citation Index (RSCI) until February 2022. Inclusion criteria for the meta-analysis were controlled trials, trials using the reference drug for RF Ursofalk in one of the groups, diagnosis and subsequent assessment of the dynamics of resolution of BS according to transabdominal ultrasound, the absence of simultaneous use of other therapy that could affect therapeutic outcomes, a documented endpoint, which reflects the percentage of the total resolution of the BS in each of the compared groups. Results. The final analysis included 6 studies involving 671 patients with BS (324 with Ursophalc, 347 with other UDCA). When using any UDCA preparations, the generalized frequency of BS dissolution within 3 months was 52.010% (95% confidence interval CI 36.55467.272; I2=94.07%), and after 6 months 78.204% (95% CI 67.84087.024; I2=86.90%). When using the RF reference drug Ursofalk, the generalized frequency of dissolution of BS during 3 months of therapy was 64.826% (95% CI 49.24278.941; I2=87.53%), while when using other UDCA drugs it was 39.187% (95% CI 17.52063.390; I2=95.24%). Ursofalk was more effective than other UDCA preparations (odds ratio OR 3.183; 95% CI 1.495-6.777; I2=74.52%). A similar trend persisted when evaluating the effectiveness of a 6-month course of therapy (OR 4.614; 95% CI 2.8817.388; I2=26.41%). Thus, the generalized frequency of dissolution of BS in the Ursofalk groups was 88.381% (95% CI 80.89094.198; I2=64.98%), and for other UDCA drugs 65.978% (95% CI 60.12571.491; I2=43.22%). Conclusion. This meta-analysis demonstrated that the reference drug UDCA for RF (Ursofalk) is more effective than generic UDCA drugs from other manufacturers in diluting BS.

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