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PBC more common in women, Caucasians, older patients in U.S.

The prevalence of primary biliary cholangitis in the United States was highest among women, white patients and patients aged 61 years to 70 years, according to a survey of patients under routine care.

“The Fibrotic Liver Disease (FOLD) Consortium has been developed to address [PBC] knowledge gaps with the primary goal of examining PBC epidemiology, natural history, and treatment within a geographically and racially diverse population of patients under routine clinical care in the United States,” Mei Lu, PhD, from the Henry Ford Health System, and colleagues wrote.

Among 14.5 million patients seen at one of 11 FOLD health systems between 2003 to 2014, Lu and colleagues identified 4,241 cases of “true” PBC.

After adjusting for region and demographic characteristics, PBC was more common among women than men (42.8 vs. 11.1 per 100,000) and white patients than African-American patients (29.6 vs. 19.7 per 100,000).

Prevalence increased concurrently with age, peaking at 44.7 per 100,000 among patients aged 61 years to 70 years.

Additionally, the prevalence of PBC was also higher in the U.S. south compared with other regions (27.8 per 100,000).

Multivariate analysis showed that region, sex, race, age at index date, elevated alkaline phosphatase and bilirubin levels correlated significantly with receipt of ursodeoxycholic acid. Men were less likely to receive UDCA than women (OR = 0.6; 95% CI, 0.5-0.7) and African-American patients were less likely to receive treatment than white patients (OR = 0.5; 95% CI, 0.4-0.7).

“Given that our sample is drawn from a geographically diverse group of nontertiary care health systems, our prevalence estimation may be generalizable to the U.S. population,” Lu and colleagues wrote. “Future FOLD studies will help describe the natural history and clinical management of PBC in the United States.” – by Talitha Bennett

Disclosure: Lu reports receiving grant or research support from Gilead Pharmaceuticals. Please see the full study for the other authors’ relevant financial disclosures.