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.
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