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Conflict of interest: No Introduction and Objectives: Primary biliary cholangitis (PBC) is a chronic, progressive, autoimmune liver disease characterized by the destruction of the small bile ducts within the liver. Ursodeoxycholic acid (UDCA) is the first-line treatment for PBC, shown to improve liver biochemistry and delay disease progression. All biochemical criteria for response recommend a threshold of alkaline phosphatase (ALP) that is higher than the ULN, because those scores have shown a lower disease progression, liver related events and overall mortality. The impact of achieving normalization of ALP, compared to conventional biochemical scores is unknown, but it's relevance, particularly in countries without universal access to liver transplantation could be significant. Patients / Materials and Methods: This is a single center, retrospective, propensity score-matched cohort study, which included all patients with PBC and chronic liver disease, confirmed by liver biopsy that were followed by the hepatology clinic from January 1st, 2015 to March 1st 2024 under treatment with UDCA. All demographic, clinical and biochemical characteristics were obtained. A biochemical response was defined according to the Toronto criterion, with an ALP |
