The efficacy of ursodeoxycholic acid (UDCA) combined with s-adenosylmethionine (SAMe, heptral) and UDCA alone was studied in the treatment of 19 patients (age 36-57 years) with primary biliary cirrhosis (PBC). UDCA was given in a dose 10 mg/kg/day, heptral--in a dose 800-1600 mg/day. It was found that UDCA + SAMe treatment results in earlier and longer remission. Normalization of biochemical indicators of cholestase (levels of serum bilirubin, cholesterol, total bile acids, alkaline phosphatase, 5-nucleotidase and gamma-glutamyl transpeptidase) was recorded in 33% patients, cholestase diminished in the rest patients. Heptral potentiates cytoprotective and anticholestatic actions of UDCA but does not essentially influence its immunomodular and antiapoptotic effects.
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