Rate of non-response to ursodeoxycholic acid in a large real-world cohort of primary biliary cholangitis patients in Italy

被引：9

作者：

Vespasiani-Gentilucci, Umberto ^{[1
]}

Rosina, Floriano ^{[2
]}

Pace-Palitti, Valeria ^{[3
]}

Sacco, Rodolfo ^{[4
]}

Pellicelli, Adriano ^{[5
]}

Chessa, Luchino ^{[6
]}

De Vincentis, Antonio ^{[1
]}

Barlattani, Michela ^{[7
]}

Barlattani, Angelo ^{[7
]}

Feletti, Valentina ^{[8
]}

Mussetto, Alessandro ^{[8
]}

Zolfino, Teresa ^{[9
]}

Russello, Maurizio ^{[10
]}

Cozzolongo, Raffaele ^{[11
]}

Garrucciu, Giovanni ^{[12
]}

Niro, Grazia ^{[13
]}

Bacca, Donato ^{[14
]}

Bertino, Gaetano ^{[15
]}

Claar, Ernesto ^{[16
]}

Ascione, Antonio ^{[17
]}

D'Adamo, Giuseppe ^{[18
]}

Adinolfi, Luigi Elio ^{[19
]}

Scifo, Gaetano ^{[20
]}

Izzi, Antonio ^{[21
]}

Barbon, Valeria ^{[22
]}

Cannavo, Maria Rita ^{[23
]}

Cardinale, Giada ^{[24
]}

Clementi, Carlo ^{[25
]}

D'Anto, Maria ^{[26
]}

Di Candilo, Francesco ^{[27
]}

Di Stefano, Marco ^{[28
]}

Fimiani, Basilio ^{[29
]}

Fontana, Rosanna ^{[30
]}

Frazzetto, Evelise ^{[31
]}

Francavilla, Ruggiero ^{[32
]}

Grasso, Alessandro ^{[33
]}

Losito, Francesco ^{[34
]}

Madonia, Salvatore ^{[35
]}

Marrone, Aldo ^{[36
]}

Mazziotti, Raffaele ^{[37
]}

Picardi, Antonio ^{[38
]}

Puoti, Claudio ^{[39
]}

Ricchiuti, Angelo ^{[40
]}

Storato, Silvia ^{[41
]}

Tarquini, Pierluigi ^{[42
]}

Tundo, Paolo ^{[43
]}

Ubalducci, Giuseppina ^{[44
]}

机构：

[1] Univ Campus Biomed Rome, Internal Med & Hepatol, Rome, Italy

[2] Med Team Torino, Turin, Italy

[3] ASL Pescara, Pescara, Italy

[4] Univ Hosp, Dept Gastroenterol, Pisa, Italy

[5] San Camillo Hosp, Liver Unit, Rome, Italy

[6] Univ Hosp Cagliari, Liver Unit, Cagliari, Italy

[7] ASL RM A, Rome, Italy

[8] Santa Maria Croci Hosp, Gastroenterol Unit, Ravenna, Italy

[9] Brotzu Hosp, Dept Gastroenterol, Cagliari, Italy

[10] Arnas Garibaldi, Liver Unit, Catania, Italy

[11] S de Bellis Reseach Hosp, Natl Inst Gastroenterol, Gastroenterol Unit, Bari, Italy

[12] Sassari Univ Hosp, Gen Med & Med Pathol, Sassari, Italy

[13] San Giovanni Rotondo, Casa Sollievo Sofferenza Inst, Dept Gastroenterol, Foggia, Italy

[14] Casarano Hosp, Internal Med Unit, Lecce, Italy

[15] Univ Hosp, Policlin Vittorio Emanuele, Dept Hepatol, Catania, Italy

[16] Betania Hosp, Dept Hepatol, Naples, Italy

[17] Fatebenefratelli Hosp, Dept Hepatol, Naples, Italy

[18] Umberto I Hosp ASL Salerno, Dept Gen Med, Nocera Inferiore, Italy

[19] Luigi Vanvitelli Univ Campania, Dept Internal Med, Naples, Italy

[20] Umberto I Hosp, Dept Infect Dis, Siracusa, Italy

[21] D Cotugno Hosp, Dept Infect Dis, Naples, Italy

[22] SS Antonio & Biagio & Cesare Arrigo Hosp, Infect Dis, Alessandria, Italy

[23] Arnas Garibaldi, Liver Unit, Catania, Italy

[24] Casarano Hosp, Internal Med Unit, Lecce, Italy

[25] Santo Volto Nursing Home, Liver Unit, Santa Marinella, Italy

[26] Santa Maria Grazie Hosp, Pozzuoli, Italy

[27] Santa Maria Misericordia Hosp, Infect Dis Unit, Perugia, Italy

[28] Umberto I Hosp, Infect Dis Unit, Siracusa, Italy

[29] Nocera Inferiore Hosp, Nocera Inferiore, Italy

[30] Casa Sollievo Sofferenza Inst, Gastroenterol, San Giovanni Rotondo, Italy

[31] Univ Hosp, Policlin Vittorio Emanuele, Hepatol, Catania, Italy

[32] Outpatient Clin, Infect Dis, Andria, Italy

[33] ASL2 Savonese, Gastroenterol, Savona, Italy

[34] S de Bellis Reseach Hosp, Natl Inst Gastroenterol, Gastroenterol Unit, Castellana Grotte, Italy

[35] Vincenzo Cervello, Palermo, Italy

[36] Luigi Vanvitelli Univ Campania, Internal Med, Naples, Italy

[37] ASL Latina, Hepatol, Latina, Italy

[38] Univ Campus Biomed Rome, Internal Med & Hepatol, Rome, Italy

[39] INI Res Inst & Clin, Liver Unit, Grottaferrata, Italy

[40] Univ Hosp, Gastroenterol, Pisa, Italy

[41] Sacro Cuore Inst Don Calabria, Gastroenterol, Verona, Italy

[42] G Mazzini Hosp, Infect Dis Unit, Teramo, Italy

[43] S Caterina Novella Hosp, Infect Dis Unit, Galatina, Italy

[44] Vasto Hosp, Gastroenterol, Vasto, Italy

来源：

SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY | 2019年 / 54卷 / 10期

关键词：

Primary biliary cholangitis; real-world; ursodeoxycholic acid; non-responder; BIOCHEMICAL RESPONSE; LIVER FIBROSIS; SCORING SYSTEM; CIRRHOSIS; EPIDEMIOLOGY; PROGRESSION; PROGNOSIS; ELASTOGRAPHY;

D O I：

10.1080/00365521.2019.1669702

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and aim: Response to ursodeoxycholic acid (UDCA) is crucial for the prediction of primary biliary cholangitis (PBC) prognosis, and different response criteria were validated and proposed by reference centers for PBC. To date, rates of non-response to UDCA from real-world series are lacking. Methods: Hepatology/Gastroenterology centers belonging to 'Club Epatologi Ospedalieri' (CLEO) and 'Associazione Italiana Gastroenterologi Ospedalieri' (AIGO) were invited to participate in the study, and asked to extract all patients followed for PBC, without any selection or exclusion, and fill in the database provided. Results: Thirty-four centers were enrolled throughout Italy, for a total of 713 patients. None of these centers, except one, had a hepatology outpatient clinic devoted to the care of patients with autoimmune liver diseases. After excluding 79 cases of PBC/autoimmune hepatitis overlaps, 634 patients were analyzed: mean age, 64.4 +/- 12.0 years; 91.2% females; F/M 10.3/1. For patients with at least 1 year of UDCA treatment (583), rates of non-response to UDCA were evaluated according to the Paris-I/-II, Toronto and GLOBE criteria, and compared with those in the original cohorts: 27% vs 39% in Paris-I cohort; 39.6% vs 52% in Paris-II; 20.1% vs 43.5% in Toronto; 15.7% vs 30% in GLOBE (age-specific cutoffs). Mean alkaline phosphatase levels on UDCA treatment, and the age-adjusted prevalence of F3/F4 fibrosis, appeared lower in this PBC population than in reference cohorts. Conclusions: A mean similar to 15% better response to UDCA is observed in a real-world PBC population, probably due to migration of some of most severe/advanced cases to PBC referral centers.

引用

页码：1274 / 1282

页数：9

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