Clinical and Biochemical Effectiveness of Ursodeoxycholic acid and S-adenosylmethionine in Intrahepatic Cholestasis of Pregnancy: An Observational Study in Kashmiri Population

Abstract

Background: Intrahepatic cholestasis of pregnancy (ICP) occurs in the last trimester of pregnancy1 and is characterized by pruritus and raised biochemical markers. Currently, used drugs for treating ICP include ursodeoxycholic acid (UDCA) and S-adenosyle methionine (SAMe). In our study we are comparing both the drugs in pregnancy induced cholestasis in terms of clinical effectiveness, biochemical changes, as no such study has been done so far in our setup.
Materials and Methods: Patients were divided into two groups A and B. Group A was given 300 mg of (UDC) twice daily. Group B was given 400 mg (SAM) twice daily. Both the groups were first evaluated for clinical and biochemical changes at day one and record was kept. Patients in both the groups were given the drugs as described above. After two weeks both the groups were monitored for clinical improvements and after four weeks both groups were investigated for clinical and biochemical improvements. The efficacy of two drugs was established.
Results: In our study we discover that both the drugs used in the study were effective in terms of both clinical and biochemical improvement in ICP. The bilurubin, ALT, AST and ALP levels in SAM group before treatment were 1.70 ± 0.17 mg/dL, 39.31 ± 8.45 IU/L, 54.1 ± 9.09 IU/L and 175.96 ± 22.12 IU/L, respectively. After treatment, the respective values were 1.54 ± 0.66, 36.67 ± 7.67, 56.17 ± 7.45, and 169.67 ± 19.98. The bilurubin, ALT, AST and ALP levels in UDC group before treatment were 1.80 ± 0.07, 49.25 ± 4.92, 54.35 ± 5.13, and 166.5 ± 18.23, respectively. After treatment the values were 0.84 ± 0.06, 36.25 ± 7.67, 35.67 ± 5.64, and 95.55 ± 23.12, respectively. Pruritus improved in both the groups, but more in UDCA group.
Conclusion: UDCA is a better drug for improving biochemical and clinical parameters as compared to SAM.