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Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis
Gazi Yasargil Educ & Res Hosp, Dept Gastroenterol, Diyarbakir, Turkey.
Istanbul Okmeydani Educ & Res Hosp, Dept Rheumatol, Istanbul, Turkey.ORCID iD: 0000-0002-8109-826X
Orebro Univ, Fac Med & Hlth, Dept Gastroenterol, Orebro, Sweden.
Univ Alberta, Div Gastroenterol, Edmonton, AB, Canada;Univ Alberta, Liver Unit, Edmonton, AB, Canada.
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2019 (English)In: American Journal of Gastroenterology, ISSN 0002-9270, E-ISSN 1572-0241, Vol. 114, no 7, p. 1101-1108Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Risk stratification based on biochemical variables is a useful tool for monitoring ursodeoxycholic acid (UDCA)-treated patients with primary biliary cholangitis (PBC). Several UDCA response criteria and scoring systems have been proposed for risk prediction in PBC, but these have not been validated in large external cohorts.

METHODS: We performed a study on data of 1746 UDCA-treated patients with PBC from 25 centers in Europe, United States, and Canada. The prognostic performance of the risk scoring systems (GLOBE and UK-PBC) and the UDCA response criteria (Barcelona, Paris I, Paris II, Rotterdam, and Toronto) were evaluated. We regarded cirrhosis-related complications (ascites, variceal bleeding, and/or hepatic encephalopathy) as clinical end points.

RESULTS: A total of 171 patients reached a clinical end point during a median 7 years (range 1-16 years) of follow-up. The 5-, 10- and 15-year adverse outcome-free survivals were 95%, 85%, and 77%. The GLOBE and UK-PBC scores predicted cirrhosis-related complications better than the UDCA response criteria. The hazard ratio (HR) for a 1 standard deviation increase was HR 5.05 (95% confidence interval (CI): 4.43-5.74, P < 0.001) for the GLOBE score and HR 3.39 (95% CI: 3.10-3.72, P < 0.001) for the UK-PBC score. Overall, the GLOBE and UK-PBC risk scores showed similar and excellent prognostic performance (C-statistic, 0.93; 95% CI: 0.91%-95% vs 0.94; 95% CI: 0.91%-0.96%).

DISCUSSION: In our international, multicenter PBC cohort, the GLOBE and UK-PBC risk scoring systems were good predictors of future cirrhosis-related complications.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2019. Vol. 114, no 7, p. 1101-1108
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:uu:diva-391961DOI: 10.14309/ajg.0000000000000290ISI: 000476563000018PubMedID: 31241547OAI: oai:DiVA.org:uu-391961DiVA, id: diva2:1346182
Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2019-08-27Bibliographically approved

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