Treatment response to ursodeoxycholic acid in primary biliary cholangitis: A systematic review and meta-analysis

被引：13

作者：

Gazda, Jakub ^{[1
,2
]}

Drazilova, Sylvia ^{[1
,2
]}

Gazda, Matej ^{[3
]}

Janicko, Martin ^{[1
,2
]}

Koky, Tomas ^{[1
,2
]}

Macej, Marian ^{[1
,2
]}

Carbone, Marco ^{[4
,5
]}

Jarcuska, Peter ^{[1
,2
]}

机构：

[1] Pavol Jozef Safarik Univ, Dept Internal Med 2, Trieda SNP 1, Kosice 04012, Slovakia

[2] Louis Pasteur Univ Hosp, Trieda SNP 1, Kosice 04012, Slovakia

[3] Tech Univ Kosice, Intelligent Informat Syst Lab, Bozeny Nemcovej 32, Kosice 04201, Slovakia

[4] Univ Milano Bicocca, Div Gastroenterol, Piazza Ateneo Nuovo 1, I-20126 Milan, Italy

[5] Univ Milano Bicocca, Ctr Autoimmune Liver Dis, Piazza Ateneo Nuovo 1, I-20126 Milan, Italy

来源：

DIGESTIVE AND LIVER DISEASE | 2023年 / 55卷 / 10期

关键词：

Primary biliary cholangitis; Ursodeoxycholic; UDCA response; Barcelona; Paris-1; Paris-2; Rotterdam; Toronto; UK-PBC Risk score; GLOBE Score; Systematic review; Meta-analysis; EARLY BIOCHEMICAL RESPONSE; PLACEBO-CONTROLLED TRIAL; LONG-TERM PROGNOSIS; EXTERNAL VALIDATION; TREATED PATIENTS; CLINICAL-TRIALS; END-POINTS; CIRRHOSIS; PREDICTION; SCORE;

D O I：

10.1016/j.dld.2022.12.010

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Several ursodeoxycholic acid (UDCA) treatment response definitions have been introduced in primary biliary cholangitis (PBC). However, the lack of a gold standard results in heterogeneity in second-line treatment research and clinical practice.Aims: This study aimed to explore which UDCA treatment response endpoint serves as the most accurate predictive model of long-term outcome.Methods: A systematic review and meta-analysis of UDCA treatment response endpoints (and corresponding validations) were performed.Results: Sixteen individual UDCA treatment response endpoints and 96 external validations were found. Barcelona, Paris-1, Paris-2, Rotterdam, Toronto and GLOBE and UK-PBC Risk Scores are currently most robustly validated in external populations. The results show that the continuous models (GLOBE and UK-PBC Risk Scores) serve as the most accurate predictive models. Besides standard UDCA treatment response endpoints, the alkaline phosphatase and total bilirubin normalization has been suggested as a new therapeutic target.Conclusions: The GLOBE and UK-PBC Risk Scores are the most suitable for the real-world allocation of second-line therapies (obeticholic acid and fibrates). However, in the wake of the recent findings, alkaline phosphatase and total bilirubin normalization should be the primary outcome in trial research in PBC. (c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

引用

页码：1318 / 1327

页数：10