Indian Journal of Gastroenterology

, Volume 31, Issue 2, pp 69–74 | Cite as

Ursodeoxycholic acid in patients with ulcerative colitis and primary sclerosing cholangitis for prevention of colon cancer: a meta-analysis

  • Imran Ashraf
  • Abhishek Choudhary
  • Murtaza Arif
  • Michelle L. Matteson
  • Hazem T. Hammad
  • Srinivas R. Puli
  • Matthew L. Bechtold
Original Article



Colon cancer risk is high in patients with ulcerative colitis (UC) and primary sclerosing cholangitis (PSC). Ursodeoxycholic acid has been shown to have some promise as a chemopreventive agent. A meta-analysis was performed to compare the efficacy of ursodeoxycholic acid in the prevention of colonic neoplasia in patients with UC and PSC.


Multiple databases were searched (January 2011). Studies examining the use of ursodeoxycholic acid vs. no ursodeoxycholic acid or placebo in adult patients with UC and PSC were included. Data were extracted in standard forms by two independent reviewers. Meta-analysis for the effect of ursodeoxycholic acid was performed by calculating pooled estimates of adenoma or colon cancer formation by odds ratio (OR) with random effects model. Heterogeneity was assessed by calculating the I 2 measure of inconsistency. RevMan 5 was utilized for statistical analysis.


Four studies (n = 281) met the inclusion criteria. The studies were of adequate quality. Ursodeoxycholic acid demonstrated no overall improvement in adenoma (OR 0.53; 95 % CI: 0.19−1.48, p = 0.23) or colon cancer occurrence (OR 0.50; 95 % CI: 0.18−1.43, p = 0.20) as compared to no ursodeoxycholic acid or placebo in patients with UC and PSC.


Ursodeoxycholic acid use in patients with UC and PSC does not appear to decrease the risk of adenomas or colon cancer.


Chemoprevention Colorectal cancer Primary sclerosing cholangitis Ulcerative colitis Ursodeoxycholic acid Ursodiol 


Financial support


Potential competing interests



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Copyright information

© Indian Society of Gastroenterology 2012

Authors and Affiliations

  • Imran Ashraf
    • 1
  • Abhishek Choudhary
    • 1
  • Murtaza Arif
    • 1
  • Michelle L. Matteson
    • 1
  • Hazem T. Hammad
    • 1
  • Srinivas R. Puli
    • 2
  • Matthew L. Bechtold
    • 1
  1. 1.Division of Gastroenterology and Hepatology, CE405, DC 043.00University of Missouri Health Sciences CenterColumbiaUSA
  2. 2.OSF MG GastroenterologyPeoriaUSA

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