P-109 ALKALINE PHOSPHATASE AND CIRRHOSIS AT DIAGNOSIS ARE ASSOCIATED WITH DEEP RESPONSE TO URSODEOXYCHOLIC ACID IN PRIMARY BILIARY CHOLANGITIS

No Primary biliary cholangitis is a chronic and progressive autoimmune liver disease, whose prognosis can be improved by normalizing alkaline phosphatase and bilirubin. While ursodeoxycholic acid (UDCA) is first line standard of care, approximately 40% of patients exhibit incomplete response. We aimed to identify prognostic markers for deep response to UDCA therapy at presentation. Data from the Brazilian Cholestasis Study Group cohort were analyzed retrospectively. Patients were assessed for deep response (defined as normalization of alkaline phosphatase and bilirubin) after 1 year of UDCA treatment. With the purpose of selecting the set of relevant variables related to the deep response for a parsimonious multivariate model, we applied the Varrank algorithm. Additionally, the performance of the UDCA response score in predicting deep response was evaluated. A total of 297 patients were analyzed, with 57.2% achieving an adequate response according to the Toronto criteria, while 22.9% reached deep response. Cirrhosis (OR 0.460; 95% CI 0.225-0.942; p=0.034) and elevated baseline alkaline phosphatase levels (OR 0.629; 95% CI 0.513-0.770; p<0.001) were associated with reduced odds of deep response. The UDCA response score exhibited moderate discrimination power (AUROC=0.769) but lacked calibration. Baseline ALP, and cirrhosis at diagnosis emerge as the most important prognostic factors to predict normalization of alkaline phosphatase and bilirubin after UDCA. The UDCA response score is inadequate for predicting deep response in the Brazilian PBC population.

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Publication Details

Journal
Annals of Hepatology
Published
2024-12-01
DOI
https://doi.org/10.1016/j.aohep.2024.101723
Primary Topic
Liver Disease Diagnosis and Treatment
Type
article
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article

P-109 ALKALINE PHOSPHATASE AND CIRRHOSIS AT DIAGNOSIS ARE ASSOCIATED WITH DEEP RESPONSE TO URSODEOXYCHOLIC ACID IN PRIMARY BILIARY CHOLANGITIS

Mateus Jorge Nardelli, Eduardo Luiz Rachid Cançado, Cláudia Alexandra Pontes Ivantes, Fábio Heleno de Lima Pace et al.
Annals of Hepatology
Liver Disease Diagnosis and Treatment
article

P-109 ALKALINE PHOSPHATASE AND CIRRHOSIS AT DIAGNOSIS ARE ASSOCIATED WITH DEEP RESPONSE TO URSODEOXYCHOLIC ACID IN PRIMARY BILIARY CHOLANGITIS

Mateus Jorge Nardelli, Eduardo Luiz Rachid Cançado, Cláudia Alexandra Pontes Ivantes, Fábio Heleno de Lima Pace, Elze Maria Gomes Oliveira, Luciana Costa Faria, Maria Lúcia Gomes Ferraz, Mário Guimarães Pessôa, Paulo Lisboa Bittencourt, Cláudia Alves Couto, Liliana Sampaio Costa Mendes, Cristiane Alves Villela‐Nogueira, Vivian Rotman, Débora Raquel Benedita Terrabuio, Michelle Harriz Braga, Izabelle Venturini Signorelli, Patrícia da Silva Fucuta, Guilherme Grossi Lopes Cançado, Gabriela Perdomo Coral, Marlone Cunha‐Silva, Valéria Ferreira de Almeida e Borges, Liana Codés, Nathália Mota de Faria Gomes, M. Beatriz P.P. Oliveira, Simone Muniz Carvalho Fernandes da Cunha
article en

Abstract

No Primary biliary cholangitis is a chronic and progressive autoimmune liver disease, whose prognosis can be improved by normalizing alkaline phosphatase and bilirubin. While ursodeoxycholic acid (UDCA) is first line standard of care, approximately 40% of patients exhibit incomplete response. We aimed to identify prognostic markers for deep response to UDCA therapy at presentation. Data from the Brazilian Cholestasis Study Group cohort were analyzed retrospectively. Patients were assessed for deep response (defined as normalization of alkaline phosphatase and bilirubin) after 1 year of UDCA treatment. With the purpose of selecting the set of relevant variables related to the deep response for a parsimonious multivariate model, we applied the Varrank algorithm. Additionally, the performance of the UDCA response score in predicting deep response was evaluated. A total of 297 patients were analyzed, with 57.2% achieving an adequate response according to the Toronto criteria, while 22.9% reached deep response. Cirrhosis (OR 0.460; 95% CI 0.225-0.942; p=0.034) and elevated baseline alkaline phosphatase levels (OR 0.629; 95% CI 0.513-0.770; p<0.001) were associated with reduced odds of deep response. The UDCA response score exhibited moderate discrimination power (AUROC=0.769) but lacked calibration. Baseline ALP, and cirrhosis at diagnosis emerge as the most important prognostic factors to predict normalization of alkaline phosphatase and bilirubin after UDCA. The UDCA response score is inadequate for predicting deep response in the Brazilian PBC population.

Annals of HepatologyVol. 29
Universidade Federal de Juiz de Fora (BR), Universidade Federal de Minas Gerais (BR), Universidade Federal do Rio de Janeiro (BR), Universidade Federal da Bahia (BR), Universidade Estadual de Campinas (UNICAMP) (BR), Hospital de Base (BR), Universidade Brasil (BR), Real Hospital Português (BR), Centro Universitário Lusíada (BR), Hospital del Salvador (CL), Faculdade Ceres (BR), Department of Aerospace Science and Technology (BR), Hospital Nossa Senhora das Graças (BR), Universidade Federal de Uberlândia (BR), Universidade Federal do Estado do Rio de Janeiro (BR), Universidade Federal de São Paulo (BR)
Openalex Percentile: Top 66%
Liver Disease Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
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