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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 24% Improvement Relative Risk Hospitalization 19% Death/hospitalization 21% UDCA for COVID-19  Costello et al.  Prophylaxis Is prophylaxis with ursodeoxycholic acid beneficial for COVID-19? Retrospective 11,305 patients in the United Kingdom (Mar 2020 - Dec 2022) Lower hospitalization (p=0.016) and death/hosp. (p=0.0049) Costello et al., medRxiv, December 2023 Favors ursodeoxycholic acid Favors control

Ursodeoxycholic acid and severe COVID-19 outcomes in people with liver disease: a cohort study using the OpenSAFELY platform

Costello et al., medRxiv, doi:10.1101/2023.12.11.23299191
Dec 2023  
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OpenSAFELY retrospective 11,320 primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) patients showing lower risk of COVID-19 hospitalization or death with ursodeoxycholic acid (UDCA) treatment.
risk of death, 24.0% lower, HR 0.76, p = 0.13, treatment 7,225, control 4,080.
risk of hospitalization, 19.0% lower, HR 0.81, p = 0.02, treatment 7,225, control 4,080.
risk of death/hospitalization, 21.0% lower, HR 0.79, p = 0.005, treatment 7,225, control 4,080.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Costello et al., 13 Dec 2023, retrospective, United Kingdom, preprint, 16 authors, study period 1 March, 2020 - 31 December, 2022.
This PaperUDCAAll
Ursodeoxycholic acid and severe COVID-19 outcomes in people with liver disease: a cohort study using the OpenSAFELY platform
Ruth E Costello, Karen Mj Waller, Rachel Smith, George F Mells, Angel Ys Wong, Anna Schultze, Viyaasan Mahalingasivam, Emily Herrett, Bang Zheng, Liang-Yu Lin, Amir Mehrkar, Sebastian Cj Bacon, Ben Goldacre, Laurie A Tomlinson, John Tazare, Christopher T Rentsch
Biological evidence suggests ursodeoxycholic acid (UDCA) -a common treatment of cholestatic liver disease -may prevent severe COVID-19 outcomes. With the approval of NHS England, we conducted a population-based cohort study using primary care records, linked to death registration data and hospital records through the OpenSAFELY-TPP platform. We estimated the hazard of COVID-19 hospitalisation or death between 1 March 2020 and 31 December 2022, comparing UDCA treatment to no UDCA treatment in a population with indication. Of 11,320 eligible individuals, 642 were hospitalised or died with COVID-19 during follow-up, 402 (63%) events among UDCA users. After confounder adjustment, UDCA was associated with a 21% (95% CI 7%-33%) relative reduction in the hazard of COVID-19 hospitalisation or death, consistent with an absolute risk reduction of 1.3% (95% CI 1.0%-1.6%). Our findings support calls for clinical trials investigating UDCA as a preventative measure for severe COVID-19 outcomes. .
Conflicts of interest BG has received research funding from the Bennett Foundation, the Laura and John Arnold Foundation, the NHS National Institute for Health Research (NIHR), the NIHR School of Primary Care Research, NHS England, the NIHR Oxford Biomedical Research Centre, the Mohn-Westlake Foundation, NIHR Applied Research Collaboration Oxford and Thames Valley, the Wellcome Trust, the Good Thinking Foundation, Health Data Research UK, the Health Foundation, the World Health Organisation, UKRI MRC, Asthma UK, the British Lung Foundation, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme; he is a Non-Executive Director at NHS Digital; he also receives personal income from speaking and writing for lay audiences on the misuse of science. BMK is also employed by NHS England working on medicines policy and clinical lead for primary care medicines data. AM is a member of RCGP health informatics group and the NHS Digital GP data Professional Advisory Group, and received consulting fee from Induction Healthcare. LAT has received research funding from MRC, Wellcome, NIHR and GSK, consulted for Bayer in relation to an observational study of chronic kidney disease (unpaid), and is a member of 4 non-industry funded (NIHR/MRC) trial advisory committees (unpaid) and MHRA Expert advisory group (Women's Health). REC has shares in AstraZeneca. VM received a grant from NIHR. AS is employed by LSHTM on a fellowship sponsored by GSK. JT received an..
Andrews, Schultze, Curtis, Hulme, Tazare et al., OpenSAFELY: Representativeness of electronic health record platform OpenSAFELY-TPP data compared to the population of England, Wellcome Open Res, doi:10.12688/wellcomeopenres.18010.1
Brevini, Maes, Webb, John, Fuchs et al., FXR inhibition may protect from SARS-CoV-2 infection by reducing ACE2, Nature, doi:10.1038/s41586-022-05594-0
Canales, Mayoral, Hernández-Huerta, Navarro, Cervantes et al., Interaction of Spike protein and lipid membrane of SARS-CoV-2 with Ursodeoxycholic acid, an in-silico analysis, Sci Rep, doi:10.1038/s41598-021-01705-5
Carey, Ali, Lindor, Primary biliary cirrhosis, The Lancet, doi:10.1016/S0140-6736(15)00154-3
Colapietro, Angelotti, Masetti, Shiffer, Pugliese et al., Ursodeoxycholic Acid Does Not Improve COVID-19 Outcome in Hospitalized Patients, Viruses, doi:10.3390/v15081738
De Vries, Groenwold, Bias of time-varying exposure effects due to time-varying covariate measurement strategies, Pharmacoepidemiol Drug Saf, doi:10.1002/pds.5328
Dyson, Beuers, Jones, Lohse, Hudson, Primary sclerosing cholangitis, The Lancet, doi:10.1016/S0140-6736(18)30300-3
Hu, Zhang, Huang, Shen, Feng et al., Effect of Ursodeoxycholic Acid on Preventing SARS-CoV-2 Infection in Patients With Liver Transplantation: a multicenter retrospective cohort study, QJM Mon J Assoc Physicians, doi:10.1093/qjmed/hcad254
John, Bastaich, Webb, Brevini, Moon et al., Ursodeoxycholic acid is associated with a reduction in SARS-CoV-2 infection and reduced severity of COVID-19 in patients with cirrhosis, J Intern Med, doi:10.1111/joim.13630
Karlsen, Folseraas, Thorburn, Vesterhus, Primary sclerosing cholangitisa comprehensive review, J Hepatol, doi:10.1016/j.jhep.2017.07.022
Lamontagne, Agarwal, Rochwerg, Siemieniuk, Agoritsas et al., A living WHO guideline on drugs for covid-19, BMJ, doi:10.1136/bmj.m3379
Lee, Wong, Chai, Lee, Lee et al., Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis, BMJ, doi:10.1136/bmj-2021-068632
Li, Zhu, Cui, Lin, Li, Protective effect of ursodeoxycholic acid on COVID-19 in patients with chronic liver disease, Front Cell Infect Microbiol
Marrone, Covino, Merra, Piccioni, Amodeo et al., Ursodeoxycholic acid does not affect the clinical outcome of SARS-CoV-2 infection: A retrospective study of propensity score-matched cohorts, Liver Int n.d, doi:10.1111/liv.15736
Mclennan, Noble, Noble, Plunkett, Wright et al., English Indices of Deprivation
Ojeda-Fernández, Baviera, Macaluso, Schena, Tettamanti et al., UDCA treatment against COVID-19: Do we have enough clinical evidence for drug repurposing, J Intern Med n.d, doi:10.1111/joim.13711
Poupon, Lindor, Parés, Chazouillères, Poupon et al., Combined analysis of the effect of treatment with ursodeoxycholic acid on histologic progression in primary biliary cirrhosis, J Hepatol, doi:10.1016/s0168-8278(03)00192-2
Rowan, Bates, Hulme, Evans, Davy et al., A comprehensive high cost drugs dataset from the NHS in England -An OpenSAFELY-TPP Short Data Report, Wellcome Open Res, doi:10.12688/wellcomeopenres.17360.1
Sivakumar, Gandhi, Shakweh, Li, Safinia et al., Widespread gaps in the quality of care for primary biliary cholangitis in UK, Frontline Gastroenterol, doi:10.1136/flgastro-2020-101713
Subramanian, Iles, Ikramuddin, Steer, Merit of an Ursodeoxycholic Acid Clinical Trial in COVID-19 Patients, Vaccines, doi:10.3390/vaccines8020320
Thuy, Bao, Moon, Ursodeoxycholic acid ameliorates cell migration retarded by the SARS-CoV-2 spike protein in BEAS-2B human bronchial epithelial cells, Biomed Pharmacother, doi:10.1016/j.biopha.2022.113021
Williamson, Walker, Bhaskaran, Bacon, Bates et al., Factors associated with COVID-19-related death using OpenSAFELY, Nature, doi:10.1038/s41586-020-2521-4
You, Ma, Efe, Wang, Jeong et al., APASL clinical practice guidance: the diagnosis and management of patients with primary biliary cholangitis, Hepatol Int, doi:10.1007/s12072-021-10276-6
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