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Feasibility of low-dose and intermittent chenodeoxycholic acid therapy of gallstones

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Abstract

Chenodeoxycholic acid, by reducing the concentration of biliary cholesterol relative to that of bile acid and phospholipid, dissolves cholesterol gallstones. This bile acid, however, has potential dose-related hepatotoxicity and causes dose-related diarrhea. Therefore, the feasibility of low-dose and intermittent therapy was assessed by studying the induction and persistence of chenodeoxycholic acid-induced biliary lipid changes. Biliary lipid composition with each of 3 doses of chenodeoxycholic acid was determined in bile samples obtained by cholecystokinin-stimulated duodenal drainage before, after one week and one month of treatment, and up to 9 weeks after discontinuation of treatment. The lowest dose that significantly reduced the relative concentration of biliary cholesterol was 250 mg/day. A significant reduction occurred one week after initiation of treatment and was maintained for 9 weeks follwing discontinuation of treatment. Thus, clinical trials of low-dose and intermittent chenodeoxycholic acid therapy for gallstone prophylaxis or dissolution are warranted.

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Authors and Affiliations

  1. Department of Gastroenterology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, 90048, Los Angeles, California

    J. W. Marks MD, G. G. Bonorris MS, A. Chung PhD, M. J. Coyne MD, R. Okun MD, J. M. Lachin ScD & L. J. Schoenfield MD

Authors
  1. J. W. Marks MD
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  2. G. G. Bonorris MS
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  3. A. Chung PhD
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  4. M. J. Coyne MD
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  5. R. Okun MD
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  6. J. M. Lachin ScD
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  7. L. J. Schoenfield MD
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Additional information

Supported in part by the National Cooperative Gallstone Study, N01-AM-32216.

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Marks, J.W., Bonorris, G.G., Chung, A. et al. Feasibility of low-dose and intermittent chenodeoxycholic acid therapy of gallstones. Digest Dis Sci 22, 856–860 (1977). https://doi.org/10.1007/BF01076159

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  • DOI: https://doi.org/10.1007/BF01076159

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