التفاصيل البيبلوغرافية
| العنوان: |
Predictive factors for decompensating events in patients with cirrhosis with primary biliary cholangitis under different lines of therapy |
| المؤلفون: |
Ampuero, Javier, Lucena, Ana, Berenguer, Marina, Hernández-Guerra, Manuel, Molina, Esther, Gómez-Camarero, Judith, Valdivia, Carlos, Gómez, Elena, Casado, Marta, Álvarez-Navascuez, Carmen, Jorquera, Francisco, García-Buey, Luisa, Díaz-González, Álvaro, Morillas, Rosa, García-Retortillo, Montserrat, Sousa, Jose M., Pérez-Medrano, Indhira, Simón, Miguel Á., Martínez, Javier, Arenas, Juan, Londoño, María Carlota, Olveira, Antonio, Fernández-Rodríguez, Conrado |
| المصدر: |
Hepatology ; ISSN 0270-9139 |
| بيانات النشر: |
Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: |
2024 |
| الوصف: |
Background and Aims: The landscape in primary biliary cholangitis (PBC) has changed with the advent of second-line treatments. However, the use of obeticholic acid (OCA) and fibrates in PBC-related cirrhosis is challenging. We assessed the impact of receiving a second-line therapy as a risk factor for decompensated cirrhosis in a real-world population with cirrhosis and PBC, and identify the predictive factors for decompensated cirrhosis in these patients. Approach and Results: Multicenter study enrolling 388 patients with PBC-cirrhosis from the Spanish ColHai registry. Biopsy (20%), ultrasound (59%), or transient elastography (21%) defined cirrhosis, and the presence of varices and splenomegaly defined clinically significant portal hypertension (CSPH). Paris-II and PBC OCA international study of efficacy criteria determined the response to ursodeoxycholic acid (UDCA), fibrates (n=93), and OCA (n=104). The incidence of decompensated cirrhosis decreased for UDCA versus OCA or fibrates in the real-world population, but they were similar considering the propensity score–matched cohort (UDCA 3.77 vs. second-line therapy 4.5 100 persons-year, respectively), as patients on second-line therapy exhibited advanced liver disease. Consequently, GGT, albumin, platelets, clinically significant portal hypertension, and UDCA response were associated with a decompensating event. OCA response (achieved in 52% of patients) was associated with bilirubin (OR 0.21 [95% CI: 0.06–0.73]) and AST (OR 0.97 [95% CI: 0.95–0.99]), while fibrate response (achieved in 55% of patients) with AST [OR 0.96 (95% CI: 0.95–0.98]). In patients treated with OCA, drug response (sHR 0.23 [95% CI: 0.08–0.64]), diabetes (sHR 5.62 [95% CI: 2.02–15.68]), albumin (sHR 0.34 [95% CI: 0.13–0.89]), and platelets (sHR 0.99 [95% CI: 0.98–1.00]) were related to decompensation. In patients treated with fibrate, drug response (sHR 0.36 (95% CI: 0.14–0.95]), albumin (sHR 0.36 (95% CI: 0.16–0.81]), and clinically significant portal hypertension (sHR 3.70 (95% CI: ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1097/hep.0000000000000826 |
| DOI: |
10.1097/HEP.0000000000000826 |
| الإتاحة: |
https://doi.org/10.1097/hep.0000000000000826Test |
| رقم الانضمام: |
edsbas.77EDE3A9 |
| قاعدة البيانات: |
BASE |
