Victoria Geenes1, Jenny Chambers2, Rshmi Khurana3, Elisabeth Wikstrom Shemer4, Winnie Sia3, Dalvinder Mandair5, Elwyn Elias5, Hanns-Ulrich Marschall6, William Hague7, Catherine Williamson8. 1. Women's Health Academic Centre, King's College London, London, United Kingdom. 2. Women's Health Research Centre, Imperial College London, London, United Kingdom. 3. Royal Alexandra Hospital, University of Alberta, Edmonton, Canada. 4. Department of Women's and Children's Health, Akademiska Hospital, Uppsala University, Uppsala, Sweden. 5. Liver Unit, University of Birmingham Trust Hospital, Birmingham, United Kingdom. 6. Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 7. Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia. 8. Women's Health Academic Centre, King's College London, London, United Kingdom. Electronic address: catherine.williamson@kcl.ac.uk.
Abstract
OBJECTIVE: To describe the use of combined ursodeoxycholic acid (UDCA) and rifampicin treatment in intrahepatic cholestasis of pregnancy (ICP). STUDY DESIGN: A questionnaire survey of 27 women with 28 affected pregnancies identified via the UK and International Obstetric Medicine forum. The clinical case notes of women with ICP treated with combined UDCA and rifampicin therapy were reviewed, and data regarding maternal and perinatal outcomes extracted. RESULTS: Serum bile acids remained high whilst taking UDCA as monotherapy. In 14 pregnancies (54%) serum bile acids decreased following the introduction of rifampicin. In 10 pregnancies (38%), there was a 50% reduction in serum bile acids. There were no adverse effects reported with either drug. CONCLUSIONS: This is the first report of the use of rifampicin in ICP. The data suggest that combined treatment with UDCA and rifampicin is an effective way of treating women with severe ICP who do not respond to treatment with UDCA alone.
OBJECTIVE: To describe the use of combined ursodeoxycholic acid (UDCA) and rifampicin treatment in intrahepatic cholestasis of pregnancy (ICP). STUDY DESIGN: A questionnaire survey of 27 women with 28 affected pregnancies identified via the UK and International Obstetric Medicine forum. The clinical case notes of women with ICP treated with combined UDCA and rifampicin therapy were reviewed, and data regarding maternal and perinatal outcomes extracted. RESULTS: Serum bile acids remained high whilst taking UDCA as monotherapy. In 14 pregnancies (54%) serum bile acids decreased following the introduction of rifampicin. In 10 pregnancies (38%), there was a 50% reduction in serum bile acids. There were no adverse effects reported with either drug. CONCLUSIONS: This is the first report of the use of rifampicin in ICP. The data suggest that combined treatment with UDCA and rifampicin is an effective way of treating women with severe ICP who do not respond to treatment with UDCA alone.
Authors: Gideon M Hirschfield; Jessica K Dyson; Graeme J M Alexander; Michael H Chapman; Jane Collier; Stefan Hübscher; Imran Patanwala; Stephen P Pereira; Collette Thain; Douglas Thorburn; Dina Tiniakos; Martine Walmsley; George Webster; David E J Jones Journal: Gut Date: 2018-03-28 Impact factor: 23.059