Treatment with ursodeoxycholic acid (UCDA) did not reduce perinatal outcomes in women with intrahepatic cholestasis of pregnancy, according to results in a new large, placebo-controlled randomized trial (PITCHES). 605 women were enrolled in the study from across 33 hospital maternity units in England and Wales and were randomly allocated to receive either UCDA (n = 305) or placebo (n = 300). The primary outcome, which included perinatal death, preterm delivery or neonatal unit admission for at least 4 h, was similar between the two treatment groups, 23% in the UCDA group versus 27% in the placebo group (adjusted risk ratio of 0.85; 95% CI 0.62–1.15). As UCDA does not seem to have any substantial clinical benefit in intrahepatic cholestasis of pregnancy, the authors recommend reconsidering the routine use of UCDA for this condition.
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Chappell, L. C. et al. Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial. Lancet https://doi.org/10.1016/S0140-6736(19)31270-X (2019)
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Ray, K. PITCHing ursodeoxycholic acid in intrahepatic cholestasis of pregnancy versus placebo. Nat Rev Gastroenterol Hepatol 16, 582 (2019). https://doi.org/10.1038/s41575-019-0201-3
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DOI: https://doi.org/10.1038/s41575-019-0201-3