Utility of pretreatment GLOBE score as a non-invasive prognostic tool in primary biliary cholangitis

Estimation of histological cirrhosis on diagnosis is useful for predicting prognosis in patients with primary biliary cholangitis (PBC). The pretreatment GLOBE score is associated with survival, but its relationship with histological cirrhosis remains unknown. We retrospectively investigated the pretreatment GLOBE score in PBC patients who had undergone liver biopsy. We analyzed the association between pretreatment GLOBE score and clinical findings, including histological cirrhosis and liver transplant (LT)-free survival rate. Among 183 patients with PBC, the pretreatment GLOBE score increased significantly with histological stage. The pretreatment GLOBE score demonstrated a high AUROC (0.868) than other noninvasive tools, with a cutoff value of 1.265 (95% CI: 1.195-1.585) for predicting histological cirrhosis. Patients with a pretreatment GLOBE score of < 1.265 had a significantly higher LT-free survival rate than those with a score of ≥ 1.265. A score of ≥ 1.265 was associated with lower LT-free survival rate independent of the presence of histological cirrhosis or GLOBE score 1 year after ursodeoxycholic acid treatment. Assessment of the pretreatment GLOBE score in PBC patients may be useful as a noninvasive prognostic tool.