Overall Survival and Treatment Outcomes in Patients With Primary Biliary Cholangitis: A 10-Year Single-Center Retrospective Cohort Study.

BACKGROUND AND AIMS: Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease predominantly affecting women, carrying significant risks of cirrhosis and liver failure. While ursodeoxycholic acid (UDCA) is the established treatment of choice, overall survival and long-term treatment outcomes in Thai PBC patients remain largely unstudied. This 10-year retrospective cohort study aimed to determine the overall survival and treatment response rates in patients with PBC in Thailand.

METHODS

We included 57 PBC patients with complete data who were followed at Srinagarind Hospital, Khon Kaen University (2014-2024). Diagnosis required fulfilling at least two standard criteria (biochemical cholestasis, positive antibodies, or histological features). The primary outcome was 10-year overall survival (OS); secondary outcomes included UDCA treatment response (evaluated using the Paris I, Paris II, and Rotterdam criteria) and survival differences based on UDCA dosage.

RESULTS

The cohort was predominantly female (80.7%) with a median age of 55.14 years at diagnosis. Cirrhosis was present in 31.6% at the baseline. The 10-year OS rate was high at 85.96%. UDCA response rates ranged from 52.63% (Paris II) to 77.19% (Paris I). Overall survival was significantly higher in UDCA responders across all criteria (e.g., Paris I: P = 0.004; Rotterdam: P < 0.0001). While UDCA over-optimal dosing (>15 mg/kg/day) showed a trend toward higher survival, this difference did not reach statistical significance (P = 0.077).

CONCLUSION

Achieving a biochemical response to UDCA is a strong and reliable predictor of improved OS in Thai PBC patients. These findings confirm favorable long-term outcomes in this population and highlight that further investigation into the optimal UDCA dosing strategy is warranted.