| [ Summary ] |
In spite of a large number of studies, the pathogenesis of primary sclerosing cholangitis (PSC) is still unknown. Therefore, no rational medical treatment has been established for PSC patients. Double blind controlled trials have been conducted for PSC patients using immunosuppressive agents such as corticosteroids, cyclosporine and methotrexate, antifibrogenic agents such as colchicine and D-penicillamine, and combinations of some two of these agents. Unfortunately, however, there has been no evidence that the above treatments would provide any beneficial effects for PSC patients. Ursodeoxycholic acid (UDCA) therapy improving biochemical parameters in PSC patients with no side effects should be applied to those with the earliest stage of PSC for prolonged period. A recent pilot study using a most potent immunosuppressant, tacrolimus (FK506), for PSC patients has achieved a marked improvement in biochemical parameters, implying further clinical benefit in the course of PSC with more prolonged observation. Broad spectrum antibiotics are most effective for recurrent bacterial cholangitis which frequently induces the progression of PSC stages. |