Clinical Outcomes and Validation of Ursodeoxycholic Acid Response Scores in Patients with Korean Primary Biliary Cholangitis: A Multicenter Cohort Study

被引：6

作者：

Chang, Jong-In ^{[1
,2
]}

Kim, Jung Hee ^{[3
]}

Sinn, Dong Hyun ^{[1
]}

Cho, Ju-Yeon ^{[4
]}

Kim, Kwang Min ^{[5
]}

Oh, Joo Hyun ^{[6
]}

Park, Yewan ^{[7
]}

Sohn, Won ^{[8
]}

Goh, Myung Ji ^{[1
]}

Kang, Wonseok ^{[1
]}

Gwak, Geum-Youn ^{[1
]}

Paik, Yong-Han ^{[1
]}

Choi, Moon Seok ^{[1
]}

Lee, Joon Hyeok ^{[1
]}

Koh, Kwang Cheol ^{[1
]}

Paik, Seung-Woon ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Samsung Med Ctr, Dept Med, Sch Med, Seoul, South Korea

[2] Chung Ang Univ, Dept Med, Gwangmyeong Hosp, Gwangmyeong, South Korea

[3] Hallym Univ, Dept Internal Med, Div Gastroenterol, Dongtan Sacred Heart Hosp, Hwaseong, South Korea

[4] Chosun Univ, Dept Internal Med, Coll Med, Gwangju, South Korea

[5] Sungkyunkwan Univ, Samsung Changwon Hosp, Dept Med, Sch Med, Chang Won, South Korea

[6] Eulji Univ, Nowon Eulji Med Ctr, Dept Med, Sch Med, Daejeon, South Korea

[7] Kyung Hee Univ, Coll Med, Dept Internal Med, Seoul, South Korea

[8] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Internal Med, Div Gastroenterol,Sch Med, Seoul, South Korea

来源：

GUT AND LIVER | 2023年 / 17卷 / 04期

关键词：

Key Words; Primary biliary cholangitis; Ursodeoxycholic acid; Ursodeoxycholic acid response score; Prognosis; LONG-TERM PROGNOSIS; BIOCHEMICAL RESPONSE; LIVER-BIOPSY; END-POINTS; CIRRHOSIS; PROGRESSION; DIAGNOSIS; RISK;

D O I：

10.5009/gnl220420

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background/Aims: The ursodeoxycholic acid (UDCA) response score (URS) was developed to identify poor responders to UDCA before treatment, in order to offer timely and proactive intervention. However, validation of the URS in Asian population is warranted. Methods: A total of 173 Asian patients diagnosed with primary biliary cholangitis (PBC) between 2007 and 2016 at seven academic institutions in Korea who started UDCA treatment were analyzed to validate the performance of URS. UDCA response was defined as an alkaline phosphatase level less than 1.67 times the upper limit of normal after 1-year of UDCA treatment. In addition, prognostic performance of URS for liver-related events, defined as newly developed hepatic decompensation or hepatocellular carcinoma was evaluated.Results: After 1 year of UDCA treatment, 133 patients (76.9%) achieved UDCA response. UDCA response rate was 98.7% for those with URS >_1.41 (n=76) and 58.8% for those with URS <1.41 (n=97). The area under the receiver operating characteristic curve of URS in predicting UDCA response was 0.84 (95% confidence interval, 0.78 to 0.88). During a median follow-up of 6.5 years, liver-related events developed in 18 patients (10.4%). Among 117 patients with PBC stage I-III by histological evaluation, the 5-year liver-related event-free survival rate differed according to the URS; 100% for URS >_1.41 and 86.5% for URS <1.41 (p=0.005).Conclusions: URS demonstrated good performance in predicting a UDCA treatment response in Asian PBC patients. In addition, the risk of liver-related events differed according to the URS for the PBC stage. Thus, URS can be used to predict the response and clinical outcome in patients with PBC. (Gut Liver, Published online March 31, 2023)

引用

页码：620 / 628

页数：9

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