Primary biliary cholangitis worsens within 5 years in almost half of cases

  • Gatselis NK & al.
  • Clin Gastroenterol Hepatol
  • 13 Aug 2019

  • International Clinical Digest
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Takeaway

  • Almost half of patients with early-stage primary biliary cholangitis (PBC) progress to a more severe stage within 5 years of follow-up, increasing their risk for cirrhosis and liver failure requiring transplant.

Why this matters

  • Surveillance is important in patients with early-stage PBC; those who progress to moderate and advanced stages may need different follow-up regimens with closer surveillance.

Study design

  • Researchers analysed the health records of patients with early-stage PBC (N=1615; mean age, 55.4±11.9 years; 91.6% women; median follow-up, 7.9 years).
  • They reviewed evaluations on progression to moderate PBC or advanced-stage PBC.
  • Funding: Intercept Pharmaceuticals; Foundation for Liver and Gastrointestinal Research.

Key results

  • During the study period, 904 patients transitioned to moderate PBC at 1 year (12.9%), 3 years (30.2%), or 5 years (45.8%).
  • Subsequent transitions to advanced PBC occurred in 201 patients 1 (3.4%), 3 (12.5%), or 5 (16.0%) years later.
  • Factors linked to transitions to moderate PBC included:
    • Baseline levels of albumin, bilirubin, and alkaline phosphatase.
    • Aspartate to alanine aminotransferase ratio.
    • Platelet count.
    • Treatment with ursodeoxycholic acid.

Limitations

  • The study was retrospective.
  • Data on cofactors such as alcohol consumption or obesity were not available.