Fibrosis stage is an independent predictor of outcome in primary biliary cholangitis despite biochemical treatment response
| Autor: | Murillo Perez, Fiorella, Hirschfield, GM, Corpechot, C, Floreani, A, Mayo, MJ, van der Meer, Adriaan, Ponsioen, CY, Lammers, Wim, Pares, A, Invernizzi, P, Carbone, M, Battezzati, PM, Nevens, F, Kowdley, KV, Thorburn, D, Mason, AL, Trivedi, PJ, Lindor, KD, Bruns, T, Dalekos, GN, Gatselis, NK, Verhelst, X, Janssen, HL, Hansen, BE, Gulamhusein, A, Grp, GPS |
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| Přispěvatelé: | Gastroenterology and Hepatology, AGEM - Digestive immunity, AGEM - Endocrinology, metabolism and nutrition, Gastroenterology & Hepatology, Murillo Perez, C, Hirschfield, G, Corpechot, C, Floreani, A, Mayo, M, van der Meer, A, Ponsioen, C, Lammers, W, Pares, A, Invernizzi, P, Carbone, M, Maria Battezzati, P, Nevens, F, Kowdley, K, Thorburn, D, Mason, A, Trivedi, P, Lindor, K, Bruns, T, Dalekos, G, Gatselis, N, Verhelst, X, Janssen, H, Hansen, B, Gulamhusein, A |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Fibrosi Biopsy Context (language use) risk stratification Chronic liver disease Gastroenterology Severity of Illness Index Biomarkers Pharmacological Cohort Studies 03 medical and health sciences 0302 clinical medicine Liver Function Tests MED/12 - GASTROENTEROLOGIA Fibrosis Predictive Value of Tests Internal medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine Primary Biliary Cholangiti Stage (cooking) Hepatology medicine.diagnostic_test business.industry Liver Cirrhosis Biliary Hazard ratio Ursodeoxycholic Acid Middle Aged medicine.disease Prognosis Treatment Outcome Liver Liver biopsy Disease Progression 030211 gastroenterology & hepatology Female business Liver function tests |
| Zdroj: | Alimentary pharmacology & therapeutics, 50(10), 1127-1136. Wiley-Blackwell Alimentary Pharmacology & Therapeutics, 50(10), 1127-1136. Wiley-Blackwell Publishing Ltd |
| ISSN: | 1365-2036 0269-2813 |
| Popis: | Background: Fibrosis stage predicts prognosis in patients with chronic liver disease independent of aetiology, although its precise role in risk stratification in patients with primary biliary cholangitis (PBC) remains undefined. Aim: To assess the utility of baseline fibrosis stage in predicting long‐term outcomes in the context of biochemical risk stratification Methods: In a large and globally representative cohort of patients with PBC, liver biopsies performed from 1980 to 2014 were evaluated. The predictive ability of histologic fibrosis stage in addition to treatment response at 1 year (Toronto/Paris‐II criteria), as well as non‐invasive markers of fibrosis (AST/ALT ratio [AAR], AST to platelet ratio index [APRI], FIB‐4), for transplant‐free survival was assessed with Cox proportional‐hazards models. Results: There were 1828 patients with baseline liver biopsy. Advanced histologic fi‐ brosis (stage 3/4) was an independent predictor of survival in addition to non‐invasive measures offibrosis with the hazard ratios ranging from 1.59 to 2.73 (P < .001). Patients with advanced histologic fibrosis stage had worse survival despite biochemical treat‐ ment response, with a 10‐year survival of 76.0%‐86.6% compared to 94.5%‐95.1% depending on the treatment response criteria used. Poor correlations were observed between non‐invasive measures of fibrosis and histologic fibrosis stage. Conclusion: Assessment of fibrosis stage grants prognostic value beyond biochem‐ ical treatment response at 1 year. This highlights the need to incorporate fibrosis stage in individual risk stratification in patients with PBC, partly to identify those that may derive benefit from novel therapies. |
| Databáze: | OpenAIRE |
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