Intrahepatic cholestasis of pregnancy: are we expecting too much from ursodeoxycholic acid? – Authors' reply

We thank Sushree Sahoo and Soumya Mahapatra for their comments. We agree that ursodeoxycholic acid treatment of intrahepatic cholestasis of pregnancy is not the panacea; new or additional treatments are certainly required, yet our results suggest that treatment with ursodeoxycholic acid can be beneficial. Ursodeoxycholic acid in intrahepatic cholestasis of pregnancy: a systematic review and individual participant data meta-analysisUrsodeoxycholic acid treatment had no significant effect on the prevalence of stillbirth in women with intrahepatic cholestasis of pregnancy, but our analysis was probably limited by the low overall event rate. However, when considering only randomised controlled trials, ursodeoxycholic acid was associated with a reduction in stillbirth in combination with preterm birth, providing evidence for the clinical benefit of antenatal ursodeoxycholic acid treatment. Full-Text PDF Open AccessIntrahepatic cholestasis of pregnancy: are we expecting too much from ursodeoxycholic acid?We read with interest the systematic review and individual participant data meta-analysis by Caroline Ovadia and colleagues1 on the role of ursodeoxycholic acid in intrahepatic cholestasis of pregnancy and its effect on fetal and maternal outcomes. Overall, the authors showed support for the clinical benefit of antenatal ursodeoxycholic acid, given that there was some reduction in the composite outcome of stillbirth and preterm delivery when only randomised controlled trials were taken into consideration, although there was no significant reduction in the whole study population of 6974 patients. Full-Text PDF