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Predictors for incomplete response to ursodeoxycholic acid in primary biliary cholangitis. Data from a national registry of liver disease

2021-07Journal article Open access
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dc.contributor.authorCortez‐Pinto, Helena
dc.contributor.authorLiberal, Rodrigo
dc.contributor.authorLopes, Susana
dc.contributor.authorMachado, Mariana V.
dc.contributor.authorCarvalho, Joana
dc.contributor.authorDias, Teresa
dc.contributor.authorSantos, Arsénio
dc.contributor.authorAgostinho, Cláudia
dc.contributor.authorFigueiredo, Pedro
dc.contributor.authorLoureiro, Rafaela
dc.contributor.authorMartins, Alexandra
dc.contributor.authorAlexandrino, Gonçalo
dc.contributor.authorCotrim, Isabel
dc.contributor.authorLeal, Carina
dc.contributor.authorPresa, José
dc.contributor.authorMesquita, Mónica
dc.contributor.authorNunes, Joana
dc.contributor.authorGouveia, Catarina
dc.contributor.authorVale, Ana Horta e
dc.contributor.authorAlves, Ana Luísa
dc.contributor.authorCoelho, Mariana
dc.contributor.authorMaia, Luís
dc.contributor.authorPedroto, Isabel
dc.contributor.authorBanhudo, António
dc.contributor.authorPinto, João Sebastião
dc.contributor.authorGomes, Marta Vargas
dc.contributor.authorOliveira, Joana
dc.contributor.authorAndreozzi, Valeska
dc.contributor.authorCalinas, Filipe
dc.contributor.authoron behalf of Liver.pt, null
dc.date.accessioned2023-11-14T11:53:43Z
dc.date.available2023-11-14T11:53:43Z
dc.date.issued2021-07
dc.description.abstractBackground: The current standard of treatment in primary biliary cholangitis (PBC) is ursodeoxycholic acid (UDCA), although a considerable proportion of patients show incomplete response resulting in disease progression. Objective: This study aimed to assess the prevalence of incomplete response to UDCA and determine associated patients' characteristics. Methods: Patients with PBC as main diagnosis were included from a national multicentric patient registry-Liver.pt. Main endpoints included incomplete response to UDCA treatment according to Barcelona, Paris I and Paris II criteria, Globe and UK PBC scores and the association between baseline characteristics and incomplete response according to Paris II criteria. Results: A total of 434 PBC patients were identified, with a mean age of 55 years and 89.2% females. Nearly half of patients were asymptomatic at diagnosis and 93.2% had positive anti-mitochondrial antibodies. Almost all patients (95.6%) had been prescribed at least one drug for PBC treatment. At the last follow-up visit, 93.3% were under treatment of which 99.8% received UDCA. Incomplete response to UDCA was observed in 30.7%, 35.3%, 53.7% and 36.4% of patients according to Barcelona, Paris I, Paris II criteria and Globe score, respectively. After adjusting for age and sex, and accordingly to Paris II criteria, the risk for incomplete biochemical response was 25% higher for patients with cirrhosis at diagnosis (odds ratio [OR] = 1.25; 95% confidence interval [95%CI]: 1.02-1.54; p = 0.033) and 35% (95%CI:1.06-1.72; p = 0.016) and 5% (OR = 1.05; 95%CI:1.01-1.10; p = 0.013) for those with elevated gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP). Conclusion: A considerable proportion of patients showed incomplete biochemical response to UDCA treatment according to Paris II criteria. Cirrhosis, elevated GGT and ALP at diagnosis were identified as associated risk factors for incomplete response. Early identification of patients at risk of incomplete response could improve treatment care and guide clinical decision to a more careful patient monitorization.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCortez-Pinto H, Liberal R, Lopes S, et al. Predictors for incomplete response to ursodeoxycholic acid in primary biliary cholangitis. Data from a national registry of liver disease. United European Gastroenterol J. 2021;9(6):699-706. doi:10.1002/ueg2.12095pt_PT
dc.identifier.doi10.1002/ueg2.12095pt_PT
dc.identifier.issn2050-6406
dc.identifier.issn2050-6414
dc.identifier.urihttp://hdl.handle.net/10400.16/2886
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/doi/10.1002/ueg2.12095pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectBarcelonapt_PT
dc.subjectGLOBEpt_PT
dc.subjectPBCpt_PT
dc.subjectParispt_PT
dc.subjectUDCApt_PT
dc.subjectpredictorspt_PT
dc.subjectprimary biliary cholangitispt_PT
dc.subjectresponsept_PT
dc.subjectscorept_PT
dc.subjectursodeoxycholic acidpt_PT
dc.titlePredictors for incomplete response to ursodeoxycholic acid in primary biliary cholangitis. Data from a national registry of liver diseasept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceEnglandpt_PT
oaire.citation.endPage706pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage699pt_PT
oaire.citation.titleUnited European Gastroenterology Journalpt_PT
oaire.citation.volume9pt_PT
person.familyNameMaia
person.familyNamePedroto
person.givenNameLuís
person.givenNameIsabel
person.identifier.orcid0000-0002-9814-6184
person.identifier.orcid0000-0001-6573-699X
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationb4528bff-008b-49e3-bfbe-76b45c947abb
relation.isAuthorOfPublicatione523f164-bf0d-4248-8069-53df9d926349
relation.isAuthorOfPublication.latestForDiscoveryb4528bff-008b-49e3-bfbe-76b45c947abb

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