Details

Autor(en) / Beteiligte

• Veer, Rozanne C.
• Harms, Maren H.
• Corpechot, Christophe
• Thorburn, Douglas
• Invernizzi, Pietro
• Janssen, Harry L. A.
• Battezzati, Pier M.
• Nevens, Frederik
• Lindor, Keith D.
• Floreani, Annarosa
• Ponsioen, Cyriel Y.
• Mayo, Marlyn J.
• Parés, Albert
• Mason, Andrew L.
• Kowdley, Kris V.
• Trivedi, Palak J.
• Hirschfield, Gideon M.
• Bruns, Tony
• Dalekos, George N.
• Gatselis, Nikolaos K.
• Verhelst, Xavier
• Lammers, Willem J.
• Hansen, Bettina E.
• Buuren, Henk R.
• Meer, Adriaan J.

Titel

Liver transplant‐free survival according to alkaline phosphatase and GLOBE score in patients with primary biliary cholangitis treated with ursodeoxycholic acid

Ist Teil von

• Alimentary pharmacology & therapeutics, 2022-11, Vol.56 (9), p.1408-1418

Ort / Verlag

England: Wiley Subscription Services, Inc

Erscheinungsjahr

2022

Quelle

Wiley

Beschreibungen/Notizen

• Summary Background After 1 year of ursodeoxycholic acid (UDCA), patients with primary biliary cholangitis (PBC) may have a normal GLOBE score despite high alkaline phosphatase (ALP) levels. Aim To assess the association between ALP and liver transplantation (LT)‐free survival according to the GLOBE score Methods Among patients with a normal or elevated GLOBE score in the Global PBC cohort, the association between ALP after 1 year of UDCA and the risk of LT/death was assessed. The LT‐free survival was compared with that of a matched general population. Results After 1 year of UDCA, ALP was associated with the risk of LT/death (aHR 1.31, 95% CI 1.003–1.72, p = 0.048) among 2729 patients with a normal GLOBE score. The 10‐year LT‐free survival among these patients with an ALP >2.0 × ULN was 94.0% (95% CI 90.1–97.9) for those <50 years, and 82.6% (95% CI 76.5–88.7) for those ≥50 years, which was significantly lower (p = 0.040) and similar (p = 0.736) to that of the matched population, respectively. The 10‐year LT‐free survival in patients ≥50 years with normal GLOBE score and normal ALP (90.8%, 95% CI 87.7–93.9) was significantly higher (p = 0.022) than the matched population. Among 1045 patients with an elevated GLOBE score, ALP was associated with LT/death only in those <50 years (aHR 1.38, 95% CI 1.06–1.81, p = 0.016). Conclusion The LT‐free survival of patients with PBC with a normal GLOBE score is optimal in case of normal ALP levels, also in relation to the general population. Despite their generally favourable prognosis, an elevated ALP level may still indicate a need for add‐on therapy. xxx