***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: Eight trials evaluated ursodeoxycholic acid versus placebo or no intervention (592 patients). The eight randomised clinical trials have a high risk of bias. Patients were treated for three months to six years (median three years). The dosage of ursodeoxycholic acid used in the trials ranged from low (10 mg/kg body weight/day) to high (28 to 30 mg/kg body weight/day). Ursodeoxycholic acid did not significantly reduce the risk of death (RR 1.00; 95% CI 0.46 to 2.20); treatment failure including liver transplantation, varices, ascites, and encephalopathy (RR 1.22; 95% CI 0.91 to 1.64); liver histological deterioration (RR 0.89; 95% CI 0.45 to 1.74); or liver cholangiographic deterioration (RR 0.60; 95% CI 0.23 to 1.57). Ursodeoxycholic acid significantly improved serum bilirubin (MD -14.6 µmol/litre; 95% CI -18.7 to -10.6), alkaline phosphatases (MD -506 IU/litre; 95% CI -583 to -430), aspartate aminotransferase (MD -46 IU/litre; 95% CI -77 to -16), and gamma-glutamyltranspeptidase (MD -260 IU/litre; 95% CI -315 to -205), but not albumin (MD -0.20 g/litre; 95% CI -1.91 to 1.50). Ursodeoxycholic acid was safe and well tolerated by patients with primary sclerosing cholangitis. We did not find enough evidence to support or refute the use of bile acids in the treatment of primary sclerosing cholangitis. However, bile acids seem to lead to a significant improvement in liver biochemistry. Therefore, more randomised trials are needed before any of the bile acids can be recommended for this indication.
Output:

Based on eight randomised clinical trials of high risk of bias, the administration of ursodeoxycholic acid to patients with primary sclerosing cholangitis did not significantly reduce mortality, hepatic decompensation, need for liver transplantation, liver histological deterioration, or radiological deterioration compared with placebo or no intervention. The use of ursodeoxycholic acid showed a statistically significant improvement of liver biochemistry. However, evidence of these beneficial effects is weak as it is produced from trials with high risk of bias and a rather small number of patients. Furthermore, these observations are at risk of outcome measure reporting bias as half or less than half of the trials reported on these outcomes. One trial assessed the self-estimated quality of life of patients with primary sclerosing cholangitis treated with ursodeoxycholic acid. No significant difference was found in any of the studied components, physical as well as mental. Based on an analysis of six of the eight included trials, the use of ursodeoxycholic acid seemed safe and well tolerated, without reports of serious adverse events. We were unable to identify trials evaluating other bile acids for patients with primary sclerosing cholangitis. Accordingly, the evidence does neither support nor refute bile acids for primary sclerosing cholangitis.