UDCA response linked to mortality in primary biliary cholangitis with cirrhosis
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In a cohort of predominantly men with primary biliary cholangitis with cirrhosis, ursodeoxycholic acid response correlated with a decrease in decompensation, all-cause, and liver-related death or transplantation, according to study results.
“In a cohort of primarily male patients with PBC cirrhosis, we demonstrate that response to UDCA is associated with a 51% reduction in death or transplantation and a greater magnitude (60%) reduction in liver-related death or transplantation,” Binu V. John, MD, MPH, from the division of hepatology, Bruce W. Carter VA Medical Center in Miami, Florida, told Healio Gastroenterology. “These data suggest that the benefit of response to UDCA continues even after the development of cirrhosis.”
John and colleagues performed a retrospective cohort study of 501 veterans with primary biliary cholangitis and compensated cirrhosis (390 men). Of these, 287 were UDCA responders and 214 were partial responders. Investigators used competing risk time-updating Cox proportional hazards models to evaluate the correlation of UDCA response with development of all-cause and liver-related mortality or transplantation, hepatic decompensation and HCC.
Results showed UDCA responders had lower unadjusted rates of hepatic decompensation than partial responders (3.8 vs. 7.9 per 100 patient-years; P < .0001) and liver-related death or transplantation (3.7 vs. 6.2 per 100 patient-years; P < .0001). UDCA correlated with a lower risk for hepatic decompensation (sub-hazard ratio [sHR] = 0.54; 95% CI, 0.31–0.95), death from any cause or transplantation (adjusted hazard ratio = 0.49; 95% CI, 0.33–0.72), and liver-related death or transplantation (sHR = 0.4; 95% CI, 0.24–0.67). However, it was not correlated with HCC (sHR = 0.39; 95% CI, 0.6–2.55).
According to results from a sensitivity analysis, the presence of portal hypertension correlated with the highest UDCA-correlated effect.
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