| Autor: |
Jakub Gazda, Sylvia Drazilova, Matej Gazda, Martin Janicko, Tomas Koky, Marian Macej, Marco Carbone, Peter Jarcuska |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. |
| ISSN: |
1878-3562 |
| Popis: |
Several ursodeoxycholic acid (UDCA) treatment response definitions have been introduced in primary biliary cholangitis (PBC). However, the lack of a gold standard results in heterogeneity in second-line treatment research and clinical practice.This study aimed to explore which UDCA treatment response endpoint serves as the most accurate predictive model of long-term outcome.A systematic review and meta-analysis of UDCA treatment response endpoints (and corresponding validations) were performed.Sixteen individual UDCA treatment response endpoints and 96 external validations were found. Barcelona, Paris-1, Paris-2, Rotterdam, Toronto and GLOBE and UK-PBC Risk Scores are currently most robustly validated in external populations. The results show that the continuous models (GLOBE and UK-PBC Risk Scores) serve as the most accurate predictive models. Besides standard UDCA treatment response endpoints, the alkaline phosphatase and total bilirubin normalization has been suggested as a new therapeutic target.The GLOBE and UK-PBC Risk Scores are the most suitable for the real-world allocation of second-line therapies (obeticholic acid and fibrates). However, in the wake of the recent findings, alkaline phosphatase and total bilirubin normalization should be the primary outcome in trial research in PBC. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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