Alkaline phosphatase and liver fibrosis at diagnosis are associated with deep response to ursodeoxycholic acid in primary biliary cholangitis.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Cançado Guilherme Grossi Lopes, Fucuta Patrícia da Silva, Gomes Nathalia Mota de Faria, Couto Cláudia Alves, Cançado Eduardo Luiz Rachid, Terrabuio Debora Raquel Benedita, Villela-Nogueira Cristiane Alves, Braga Michelle Harriz, Nardelli Mateus Jorge, Faria Luciana Costa, Oliveira Elze Maria Gomes, Rotman Vivian, Oliveira Maria Beatriz, Cunha Simone Muniz Carvalho Fernandes da, Silva Marlone Cunha da, Mendes Liliana Sampaio Costa, Ivantes Claudia Alexandra Pontes, Codes Liana, de Almeida E Borges Valéria Ferreira, Pace Fabio Heleno de Lima, Pessôa Mário Guimarães, Signorelli Izabelle Venturini, Coral Gabriela Perdomo, Bittencourt Paulo Lisboa, Ferraz Maria Lucia Gomes
Аннотация
PATIENT AND METHODS: Data from the Brazilian Cholestasis Study Group cohort were analyzed retrospectively. Patients were assessed for deep response, defined as normal alkaline phosphatase and bilirubin, after 1 year of UDCA treatment. Additionally, the performance of the UDCA response score in predicting deep response was evaluated.
RESULTS: A total of 297 patients were analyzed, with 57.2 % achieving an adequate response according to the Toronto criteria, while 22.9 % reached deep response. Cirrhosis (OR 0.460; 95 % CI 0.225-0.942; p = 0.034) and elevated baseline alkaline phosphatase levels (OR 0.629; 95 % CI 0.513-0.770; p < 0.001) were associated with reduced odds of deep response. The UDCA response score exhibited moderate discrimination power (AUROC = 0.769) but lacked calibration.
CONCLUSIONS: Baseline ALP and liver fibrosis emerge as the most important prognostic factors to predict normalization of alkaline phosphatase and bilirubin after UDCA. The UDCA response score was inadequate for predicting deep response in the Brazilian PBC population.