Cholestasis Clinical Trial
OBJECTIVES: I. Determine whether infants treated with tauroursodeoxycholic acid (TUDCA) have
a lower peak direct bilirubin, ALT, AST, glutamyltranspeptidase levels and a reduced
duration of cholestasis compared to the nontreatment arm.
II. Determine the significance of lower birth weight and longer duration of total parenteral
nutrition (TPN) on increasing risk of TPN associated cholestasis and increasing benefit from
TUDCA therapy.
III. Determine whether TUDCA therapy leads to significant reduction in the appearance of
biliary tract sludge and/or stone formation in these infants.
IV. Determine whether TUDCA therapy leads to reduced urinary excretion of potentially
hepatotoxic bile acids as compared to the untreated arm matched for birth weight and
duration of TPN.
PROTOCOL OUTLINE: This is a randomized study. Patients are stratified by birth weight.
Patients are randomized in pairs by birth weight to receive either a placebo in arm I or
tauroursodeoxycholic acid (TUDCA) in arm II. TUDCA is administered by mouth, nasogastric
tube, or gastrostomy tube twice daily. After 2 weeks of therapy, a bile sample is obtained
via a duodenal tube. An ultrasound examination of the liver and biliary tract is performed
after 2 weeks and every 3 weeks thereafter until discontinuation of therapy or until
presence of biliary tract sludge is noted on 2 consecutive examinations.
Completion date provided represents the completion date of the grant per OOPD records
;
Allocation: Randomized, Primary Purpose: Treatment
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