Prognostic Performance of Liver Stiffness Measurements in Primary Sclerosing Cholangitis: The Prospective FICUS cohort.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chazouilleres Olivier, Bellet Jonathan, Schramm Christoph, Trivedi Palak, Thorburn Douglas, Farkkila Martti, Floreani Annarosa, Pares Albert, Levy Cynthia, Beuers Ulrich, Ytting Henriette, Zigmond Ehud, Mason Andrew, Invernizzi Pietro, Lohse Ansgar, Hirschfield Gideon, Cazzagon Nora, Llovet Laura, Ponsioen Cyriel, Carbone Marco, Fuessel Katja, Pezzato Francesco, Patel Isha, Helder Jeltje, Khan Sheeba, Ben Belkacem Karima, Gaouar Farid, Monegier du Sorbier Aymeric, Housset Chantal, Lemoinne Sara, Soret Pierre-Antoine, Carrat Fabrice, Corpechot Christophe, International PSC Study Group
Аннотация
METHODS: Clinical, biological, and LSM data of adult patients with uncomplicated PSC were prospectively recorded annually for 5 years. LSM was assessed continuously or according to 3 Baveno VII classes (<10 kPa, ≥10 to <15 kPa, and ≥15 kPa). The primary end point was transplant-free survival. Adjusted hazard ratios and 95% confidence intervals were determined using time-dependent multivariable Cox regression analyses. Effect of LSM change was evaluated using joint modeling. Progression was defined by a significantly positive individual LSM slope.
RESULTS: The study analyzed 538 patients with at least 1 reliable LSM and follow-up available (median, 60.7 months; interquartile range [IQR], 48.6-66.0 months). Median baseline LSM was 7.6 kPa (IQR, 5.8-11.7 kPa). Nineteen patients died, and 72 received a transplant. Baseline LSM was strongly and independently linked to the risk of death or transplantation. For the groups 2.5 to <10 kPa, 10 to <15 kPa, and ≥15 kPa, the 5-year transplant-free survival was 93.9% (IQR, 90.3%-96.2%), 78.1% (IQR, 66.2%-86.3%), and 46.0% (IQR, 34.6%-56.7%), respectively. Progressors experienced worse transplant-free survival vs nonprogressors: adjusted hazard ratio of 3.12 (95% confidence interval, 1.55-6.24; P = .001). Each 1-kPa/y increment was associated with 18% increase in risk of death or transplantation.
CONCLUSIONS: This observational study validates the strong prognostic value of both static and dynamic LSM in PSC, as assessed by FibroScan. These results support the use of LSM as a risk stratification tool and potential surrogate end point in clinical trials.