What question did this study set out to answer?

To assess whether achieving normal alkaline phosphatase levels confers significant complication-free survival gains in patients with primary biliary cholangitis who already show an adequate response to ursodeoxycholic acid.

July 3, 2023HepatologyOpen Access

Adequate versus deep response to ursodeoxycholic acid in primary biliary cholangitis: To what extent and under what conditions is normal alkaline phosphatase level associated with complication-free survival gain?

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Authors

CCChristophe CorpechotInserm SLSara LemoinneInserm PSPierre‐Antoine SoretInserm

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Implication

Retrospective cohort study reveals normal alkaline phosphatase extends complication-free survival in primary biliary cholangitis responders, suggesting earlier consideration of second-line therapies.

Key Points

To assess whether achieving normal alkaline phosphatase levels confers significant complication-free survival gains in patients with primary biliary cholangitis who already show an adequate response to ursodeoxycholic acid.
Conducted a retrospective cohort study of 1047 patients with primary biliary cholangitis who achieved an adequate response to ursodeoxycholic acid based on Paris-2 criteria.
Evaluated time to liver-related complications, liver transplantation, or death over 4763.2 patient-years using adjusted restricted mean survival time analysis.
The overall incidence rate of complications, transplantation, or death was 17.0 per 1000 patient-years (95% CI: 13.7–21.1).
Normal alkaline phosphatase was associated with a significant absolute 10-year complication-free survival gain of 7.6 months (95% CI: 2.7–12.6, p = 0.003), whereas normal levels of other liver enzymes and bilirubin showed no significant gain.
In subgroup analysis, patients with both liver stiffness ≥ 10 kPa and age ≤ 62 years achieved a 10-year complication-free survival gain of 52.8 months (95% CI: 45.7–59.9, p < 0.001).

Cite This Study

Corpechot et al. (2023) studied this question.

synapsesocial.com/papers/6aa8e5e25b65078a7c43eafd https://doi.org/10.1097/hep.0000000000000529

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Implication

Retrospective cohort study reveals normal alkaline phosphatase extends complication-free survival in primary biliary cholangitis responders, suggesting earlier consideration of second-line therapies.

Adequate versus deep response to ursodeoxycholic acid in primary biliary cholangitis: To what extent and under what conditions is normal alkaline phosphatase level associated with complication-free survival gain?

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Cite This Study

Adequate versus deep response to ursodeoxycholic acid in primary biliary cholangitis: To what extent and under what conditions is normal alkaline phosphatase level associated with complication-free survival gain?

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