1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

URSODEOXYCHOLIC ACID MAY PREVENT GALLSTONES IN DIETERS.

Both obesity and rapid weight loss are associated with development of gallstones. This multicenter, double-blind trial evaluated whether ursodeoxycholic acid, a bile salt that decreases cholesterol secretion into bile and improves cholesterol solubility, can prevent gallstones in obese dieters. The 1004 subjects were recruited from weight management centers; all had a body mass index of 38 kg or more per square meter. They were prescribed a 520 kcal/day liquid diet for four months and were randomized to either ursodeoxycholic acid, at 300, 600, or 1200 mg daily, or to placebo. On average, subjects lost 5.8 kg per month. Sonography identified new gallstones in 28 percent of the placebo group, versus 8, 3, and 2 percent of the 300-, 600-, and 1200-mg ursodeoxycholic acid groups, respectively. One quarter of the subjects withdrew from the trial prematurely because they left the weight-loss program. Only 1.8 percent withdrew because of side effects such as constipation and headache, which were as common with placebo as with ursodeoxycholic acid. Comment: Although longer studies with fewer withdrawals are warranted, these findings are encouraging and suggest that ursodeoxycholic acid at 600 mg daily can prevent gallstones in certain high-risk patients. The 1200-mg dose appeared to yield no added benefit. This study was supported in part by the manufacturer.

— CD Mulrow

Published in Journal Watch General Medicine June 27, 1995

Citation(s):

Shiffman ML, et al. Prophylaxis against gallstone formation with ursodeoxycholic acid in patients participating in a very- low-calorie diet program. Ann Intern Med 1995 Jun 15 122 899-905.

• Original article (Subscription may be required)
• Medline abstract (Free)