Elsevier

Annals of Hepatology

Volume 18, Issue 3, May–June 2019, Pages 488-493
Annals of Hepatology

Original article
Treatment response in primary biliary cholangitis: The role of autoimmune hepatitis features

https://doi.org/10.1016/j.aohep.2018.11.006Get rights and content
Under a Creative Commons license
open access

Abstract

Introduction and aim

Primary biliary cholangitis is a rare disease with scarce epidemiological data in Southern Europe. The authors aimed to evaluate treatment response in a cohort of patients.

Materials and methods

This retrospective observational single-centre study included patients with diagnostic criteria of primary biliary cholangitis. Data on disease presentation, laboratory results, treatment and clinical endpoints were collected and analyzed.

Results

Fifty-three patients were included, 89% women, with mean age of 62 ± 15 years at diagnosis. The majority was asymptomatic (49%), tested positive for antimitochondrial antibodies (96%) and had increased alkaline phosphatase (median = 214 U/L). 75% of the patients had liver histology and the majority were in Ludwig's stage I (42%). Autoimmune hepatitis (AIH) features were found in seven patients (13%). All were treated with ursodeoxycholic acid (UDCA) and 56% achieved biochemical response at one year; patients with AIH features exhibited steeper decreases in alkaline phosphatase (p = 0.007) and reached the endpoint of 40% decrease in alkaline phosphatase more frequently (p = 0.017).

Conclusion

In conclusion a significant proportion of patients failed to achieve an adequate response to UDCA treatment. The response rate of patients with AIH features was better, which could be related to a different phenotype or to the potential impact of immunosuppressive agents.

Keywords

Overlap syndrome
Alkaline phosphatase
Ursodeoxycholic acid

Cited by (0)

1

The first and the second authors contributed equally in paper writing.