Survival of Anti-Mitochondrial Antibody-Positive and -Negative Primary Biliary Cirrhosis Patients on Ursodeoxycholic Acid Treatment

The survival of 85 anti-mitochondrial antibody (AMA)-positive (mean Mayo risk score, 5.11) and 19 AMA-negative (mean Mayo risk score, 4.77) primary biliary cirrhosis patients, under ursodeoxycholic acid not subjected to liver transplantation, was compared with the estimated survival of a simulated control group of untreated patients created with the updated Mayo model and a control group from the general population. In the first 7 years 3 AMA-negative patients died, versus 12 under the Mayo model (P=0.01), and 10 AMA-positive patients, versus 26 under the Mayo model (P<0.005), with 7 expected deaths from the general population (P<0.0001). At 10 years the cumulative survival differed in the treated patients overall (P<0.0001) but not in the early primary biliary cirrhosis (stages I–II) patients compared to the general population. Therefore the survival of our patients treated with ursodeoxycholic acid is higher than that predicted from the Mayo model. Early treatment may prolong survival.