Cheno and urso compared and contrasted.
UDCA was introduced as a gallstone dissolving agent some 5 years after COCA. Experience with urso is, therefore, more limited but the initial 5-7 years of clinical investigation for CDCA have been condensed into a mere 1-2 years for UDCA. As a result, there is now a substantial data base on which to compare the two agents. With careful patient selection, efficacy is high and comparable for both bile acids but UDCA depresses HMGCoAR activity (at least in our experience), reduces biliary cholesterol secretion, desaturates fasting duodenal bile, and dissolves cholesterol galistones at 50-66% of the CDCA dose. It is almost free from medium-range (up to 3 years) side-effects and, cost apart, UDCA is likely to replace CDCA as the medical treatment of choice for gallstones.
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