J L Damman1, E A Rodriguez2, A H Ali3, C W Buness4, K L Cox5, E J Carey2, K D Lindor6. 1. Pediatrics/Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA. 2. Gastroenterology and Hepatology, Mayo Clinic, Arizona, USA. 3. Hepatology, Mayo Clinic, Arizona, USA. 4. National Patient Advocate Foundation, Paradise Valley, AZ, USA. 5. Pediatric Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA. 6. Gastroenterology and Hepatology, Arizona State University and Mayo Clinic, Arizona, USA.
Abstract
BACKGROUND AND AIMS: PSC is an autoimmune biliary inflammatory disorder that is often associated with inflammatory bowel disease (IBD), with 50%-75% of patients with PSC having coexisting IBD, most commonly ulcerative colitis. Currently, no medical therapies have been shown to improve the disease course or slow its progression. However, ongoing research has resulted in a growing interest in the use of antibiotics for treatment of PSC, of which vancomycin is the most studied. In this review, we summarise the current evidence on the use of vancomycin in PSC and comment on future research areas of interest. METHODS: A comprehensive PUBMED and EMBASE literature search for articles on vancomycin, PSC, therapeutic options and microbiome was performed. RESULTS: Two randomised clinical trials, three case series and two case reports were included in the study. These include uncontrolled data from at least 98 patients that include promising improvements in biochemistry and imaging. Optimal dosing regimens are unclear. CONCLUSION: Vancomycin is one of the most studied antibiotics used in the treatment of PSC with promising results. There is not currently sufficient evidence to support treatment recommendations. Further research is needed to establish if vancomycin is a PSC treatment.
BACKGROUND AND AIMS: PSC is an autoimmune biliary inflammatory disorder that is often associated with inflammatory bowel disease (IBD), with 50%-75% of patients with PSC having coexisting IBD, most commonly ulcerative colitis. Currently, no medical therapies have been shown to improve the disease course or slow its progression. However, ongoing research has resulted in a growing interest in the use of antibiotics for treatment of PSC, of which vancomycin is the most studied. In this review, we summarise the current evidence on the use of vancomycin in PSC and comment on future research areas of interest. METHODS: A comprehensive PUBMED and EMBASE literature search for articles on vancomycin, PSC, therapeutic options and microbiome was performed. RESULTS: Two randomised clinical trials, three case series and two case reports were included in the study. These include uncontrolled data from at least 98 patients that include promising improvements in biochemistry and imaging. Optimal dosing regimens are unclear. CONCLUSION:Vancomycin is one of the most studied antibiotics used in the treatment of PSC with promising results. There is not currently sufficient evidence to support treatment recommendations. Further research is needed to establish if vancomycin is a PSC treatment.
Authors: Dennis D Black; Cara Mack; Nanda Kerkar; Tamir Miloh; Shikha S Sundaram; Ravinder Anand; Ashutosh Gupta; Estella Alonso; Ronen Arnon; Pinar Bulut; Saul Karpen; Chuan-Hao Lin; Philip Rosenthal; Matthew Ryan; Robert H Squires; Pamela Valentino; Sarah H Elsea; Benjamin L Shneider Journal: Hepatol Commun Date: 2019-08-29
Authors: Pamela S Tietz-Bogert; Minsuk Kim; Angela Cheung; James H Tabibian; Julie K Heimbach; Charles B Rosen; Madhumitha Nandakumar; Konstantinos N Lazaridis; Nicholas F LaRusso; Jaeyun Sung; Steven P O'Hara Journal: Int J Mol Sci Date: 2018-10-16 Impact factor: 5.923