Review article: the evidence that vancomycin is a therapeutic option for primary sclerosing cholangitis.

Autor: Damman JL; Pediatrics/Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA., Rodriguez EA; Gastroenterology and Hepatology, Mayo Clinic, Arizona, USA., Ali AH; Hepatology, Mayo Clinic, Arizona, USA., Buness CW; National Patient Advocate Foundation, Paradise Valley, AZ, USA., Cox KL; Pediatric Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA., Carey EJ; Gastroenterology and Hepatology, Mayo Clinic, Arizona, USA., Lindor KD; Gastroenterology and Hepatology, Arizona State University and Mayo Clinic, Arizona, USA.
Jazyk: angličtina
Zdroj: Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2018 Apr; Vol. 47 (7), pp. 886-895. Date of Electronic Publication: 2018 Feb 07.
DOI: 10.1111/apt.14540
Abstrakt: 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.
(© 2018 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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