Systematic review and meta-analysis of randomized controlled trials on the effects of obeticholic acid on the blood lipid profile: Insights into liver disorders and liver cancer

Eur J Pharmacol. 2020 Dec 15:889:173616. doi: 10.1016/j.ejphar.2020.173616. Epub 2020 Oct 6.

Abstract

Aim: Treatment with obeticholic acid (OCA) affects the blood lipid profile. Therefore, a meta-analysis of randomized controlled trials (RCTs) was performed to investigate the effects of OCA on blood lipids and lipoproteins.

Methods and results: The electronic databases of PubMed, Web of Science, SCOPUS, and Google Scholar were searched. The mean differences were meta-analyzed to obtain a pooled weighted mean difference (WMD) and the 95% CI across the trials using the Der Simonian and Laird random-effects method. Six (6) articles with 10 trials for low-density lipoprotein cholesterol (LDL-C), and 8 trials for high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TG) levels were included in the meta-analysis. . Most studies were conducted in patients with liver dysregulation (fatty liver, liver cancer). The pooled results showed that the levels of TC (WMD: 6.357 mg/dl) and LDL-C (WMD: 6.067 mg/dl) increased while TG (WMD: -22.417 mg/dl) decreased after treatment with OCA. A slight but significant decrease was also observed for HDL-C levels (WMD: -1.492 mg/dl). A significant non-linear response was observed only between the TG levels and the length of intervention. Larger reductions in TG levels were observed over intervention durations of less than 3 weeks, but regarding interventions for more than 3 weeks, the impact on TG was modest.

Conclusion: OCA administration causes significant increases in blood levels of TC and LDL-C while decreasing HDL-C and TG in humans. More study needed on liver cancer.

Keywords: High-density lipoprotein cholesterol; Lipids; Liver cancer; Low-density lipoprotein cholesterol; Obeticholic acid; Triglycerides.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Chenodeoxycholic Acid / analogs & derivatives*
  • Chenodeoxycholic Acid / pharmacology
  • Chenodeoxycholic Acid / therapeutic use
  • Humans
  • Lipids / antagonists & inhibitors
  • Lipids / blood*
  • Lipoproteins / antagonists & inhibitors
  • Lipoproteins / blood*
  • Liver Diseases / blood
  • Liver Diseases / drug therapy
  • Liver Neoplasms / blood*
  • Liver Neoplasms / drug therapy*
  • Randomized Controlled Trials as Topic / methods*
  • Treatment Outcome

Substances

  • Lipids
  • Lipoproteins
  • obeticholic acid
  • Chenodeoxycholic Acid