Analysis of predictive response scores to treatment with ursodeoxycholic acid in patients with primary biliary cholangitis

Autor: Mercedes Vergara, Oliver Valero, Jordi Sánchez-Delgado, Leticia Hernandez, Eduard Brunet, Mireia Miquel, Meritxell Casas, Blai Dalmau
Rok vydání: 2019
Předmět:
Zdroj: Medicina Clínica (English Edition). 152:377-383
ISSN: 2387-0206
DOI: 10.1016/j.medcle.2019.03.009
Popis: Background and objectives Primary biliary cholangitis (PBC) is an autoimmune disease that affects the small bile ducts. The only treatments currently approved in our country are ursodeoxycholic acid (UDCA) and obeticholic acid. Different indices evaluate the response after 1 year of treatment. The aim of our study was to evaluate the different predictive scores and prognostic factors of response to UDCA. Material and methods Retrospective single-centre study in which clinical and analytical data of patients diagnosed with PBC were collected from January 1987 to December 2015. The response after 1 year of treatment was evaluated using the different response scores and their concordance degree using the Kappa index. The area under the receiver operating characteristic curve (AUROC) was calculated to determine the predictive capacity of the scores. Likewise, the prognostic factors of response to treatment were analysed. Results We included 153 patients. The bivariate analysis showed a statistically significant relationship between the initial high levels of alkaline phosphatase and cholesterol and the poor response to treatment. The best AUROC was in Paris-I score (0.81). The concordance between the different scores was low. The GLOBE score was valid to evaluate the prognosis. Conclusion Basal alkaline phosphatase and cholesterol were predictors of poor outcome. The best predictive qualitative score in our cohort patients was Paris-I. There was a poor concordance between the different predictive scores. GLOBE score is valid to evaluate prognosis.
Databáze: OpenAIRE
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