The longstanding issue of the benefit of ursodeoxycholic acid in primary sclerosing cholangitis: a long-term population-based study - Report - MDSpire

The longstanding issue of the benefit of ursodeoxycholic acid in primary sclerosing cholangitis: a long-term population-based study

  • By

  • Bregje Mol

  • Kim van Munster

  • Rinse Weersma

  • Akin Inderson

  • Kirsten Boonstra

  • Joost Drenth

  • Suzanne van Meer

  • Elsemieke de Vries

  • Marcel Spanier

  • Anton Vrij

  • Tessa Verlaan

  • Femke van Duijn

  • Willemijn Ponsioen

  • Marcel Dijkgraaf

  • Cyriel Ponsioen

  • June 15, 2026

  • 0 min

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Clinical Report: Evaluating the Efficacy of Ursodeoxycholic Acid in PSC

Overview

This long-term population-based study evaluates the efficacy of ursodeoxycholic acid (UDCA) in improving transplant-free survival in patients with primary sclerosing cholangitis (PSC). The findings indicate no significant benefit of UDCA on transplant-free survival or related outcomes.

Background

Expand on the relationship between PSC and IBD, and the need for effective treatments.

Data Highlights

No significant benefit of UDCA on transplant-free survival was observed in the study.

Key Findings

  • UDCA did not improve transplant-free survival in a long-term population-based cohort.
  • The adjusted hazard ratio for transplant-free survival with UDCA was 1.13 (95% CI not specified).
  • Previous studies have shown no clinical benefit of UDCA despite biochemical improvements.
  • High-dose UDCA has been associated with increased adverse outcomes and colorectal neoplasia risk.
  • Current guidelines recommend cautious use of UDCA in PSC, emphasizing low-dose regimens.

Clinical Implications

Clinicians should be aware that UDCA does not provide a significant survival benefit in PSC patients and should consider this when discussing treatment options. The emphasis on low-dose UDCA aligns with current guidelines, which suggest monitoring biochemical responses before continuing treatment.

Conclusion

The study reinforces the notion that UDCA lacks efficacy in improving transplant-free survival in PSC, highlighting the need for further research into effective therapies for this challenging condition.

Related Resources & Content

  1. Boonstra et al., Journal of Gastroenterology, 2026 -- The longstanding issue of the benefit of ursodeoxycholic acid in primary sclerosing cholangitis: a long-term population-based study
  2. EASL Clinical Practice Guidelines on sclerosing cholangitis, 2022 -- EASL Guidelines
  3. Ursodiol for Primary Sclerosing Cholangitis, NEJM, 1997 -- Randomized trial findings
  4. Obesity Surgery — Impact of Ursodeoxycholic Acid Administration Following Bariatric Surgery on Metabolic and Inflammatory Blood Parameters
  5. Journal of Gastroenterology — Innovative Treatments for Primary Sclerosing Cholangitis: Understanding the Pathophysiology and Clinical Implications
  6. European Radiology — Noninvasive Assessment of Biochemical Response to Ursodeoxycholic Acid Therapy in Primary Biliary Cholangitis Patients Using Baseline Nonenhanced MRI
  7. the new gastroenterologist — Navigating primary sclerosing cholangitis: Diagnosis and the 5 pillars of management
  8. Navigating primary sclerosing cholangitis: Diagnosis and the 5 pillars of management
  9. Innovative Treatments for Primary Sclerosing Cholangitis: Understanding the Pathophysiology and Clinical Implications
  10. EASL Clinical Practice Guidelines on sclerosing cholangitis
  11. Ursodiol for Primary Sclerosing Cholangitis | New England Journal of Medicine
  12. The longstanding issue of the benefit of ursodeoxycholic acid in primary sclerosing cholangitis: a long-term population-based study | Journal of Gastroenterology | Springer Nature Link

Original Source(s)

The longstanding issue of the benefit of ursodeoxycholic acid in primary sclerosing cholangitis: a long-term population-based study

  • by Bregje Mol, Kim van Munster, Rinse Weersma, Akin Inderson, Kirsten Boonstra, Joost Drenth, Suzanne van Meer, Elsemieke de Vries, Marcel Spanier, Anton Vrij, Tessa Verlaan, Femke van Duijn, Willemijn Ponsioen, Marcel Dijkgraaf, Cyriel Ponsioen

  • June 15, 2026

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