The Role of Hymecromone in the Treatment of Biliary Tract Dysfunction: A Systematic Review and Meta-Analysis of Clinical Trials

Aim: comprehensive assessment of the efficacy and safety of hymecromone in the treatment of biliary tract dysfunction.

Materials and methods. A systematic review and meta-analysis of observational studies (n = 1117) selected from 5 databases (Central Scientific Medical Library, eLibrary, PubMed, Google Academy, Cochrane Library) without restrictions on publication date, devoted to the study of the use of hymecromone in patients with biliary tract dysfunction, including gallstone disease.

Results. During the meta-analysis, it was found that three-week therapy with hymecromone, 1200 mg/day, was accompanied by a change in pain intensity by –48.51 mm (95 % confidence interval (95% CI): –56.97…–40.05) on the Visual Analog Scale. Improvement in quality of life was observed according to the “Bodily Pain” subscale of the 36-Item Short-Form Health Survey (SF-36) with a mean increase of 21.69 points (95% CI: 18.23–25.16). Following three-week therapy with hymecromone, 1200 mg/day, the proportion of patients with abdominal pain relief was 70.0 % (95% CI: 59.0–81.0), flatulence — 77.0 % (95% CI: 60.0–95.0), bitter taste — 74.0 % (95% CI: 54.0–93.0). The proportion of patients with improvement of gallbladder motility was 91.0 % (95% CI: 82.0–100.0), and the proportion of patients with restoration of bile homogenicity was 70.0 % (95 % CI: 43.0–98.0). The proportion of patients with normal stool frequency increased from 60.0 % (95% CI: 9.0–100.0) to 78.0 % (95% CI: 34.0–100.0) after 3 weeks of hymecromone therapy (1200 mg/day). Monotherapy with hymecromone at doses of 600–1200 mg/day had a favorable safety profile. The probability of persistent unformed stool after 3 weeks of therapy was dose-dependent: at the end of treatment, the symptom persisted in 23.0 and 0 % of patients receiving 1200 or 600 mg/day of hymecromone, respectively.

Conclusions. Course therapy with hymecromone at the full therapeutic dose of 1200 mg/day results in regression of key clinical manifestations, including biliary pain and dyspeptic symptoms. The drug contributes to the restoration of gallbladder motility and improvement of bile rheological properties while demonstrating a favorable tolerability profile. These findings support the pathophysiological rationale for the use of hymecromone in biliary tract disorders and reinforce its applicability in routine clinical practice.

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