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Ursodeoxycholic Acid Response Is Associated With Reduced Mortality in Primary Biliary Cholangitis With Compensated

Binu V John1, Nidah S Khakoo2, Kaley B Schwartz1

  • 1Division of Hepatology, Bruce W Carter VA Medical Center, Miami, Florida, USA.

The American Journal of Gastroenterology
|May 14, 2021
PubMed

Insights

Response to ursodeoxycholic acid (UDCA) reduces liver complications and death in male primary biliary cholangitis (PBC) patients with cirrhosis. The greatest benefit was observed in those with portal hypertension.

Area of Science:

  • Hepatology
  • Clinical Medicine
  • Pharmacology

Background:

  • Primary biliary cholangitis (PBC) studies often under-represent male patients and those with cirrhosis.
  • Ursodeoxycholic acid (UDCA) is a key treatment for PBC, but its effectiveness in specific patient groups requires further investigation.

Purpose of the Study:

  • To assess the association between UDCA response and clinical outcomes in male patients with PBC and cirrhosis.
  • To evaluate the impact of UDCA response on liver-related death or transplantation, hepatic decompensation, and hepatocellular carcinoma (HCC).

Main Methods:

  • Retrospective cohort study of 501 male veterans with PBC and compensated cirrhosis.
  • Utilized competing risk time-updating Cox proportional hazards models to analyze UDCA response.
  • Follow-up included assessment of all-cause and liver-related mortality or transplantation, hepatic decompensation, and HCC development.

Main Results:

  • UDCA responders showed significantly lower rates of hepatic decompensation and liver-related death or transplantation compared to partial responders.
  • UDCA response was linked to a reduced risk of hepatic decompensation, all-cause death or transplantation, and liver-related death or transplantation.
  • No significant association was found between UDCA response and HCC development. The effect was most pronounced in patients with portal hypertension.

Conclusions:

  • UDCA response is associated with improved clinical outcomes, including reduced decompensation and mortality, in male patients with PBC cirrhosis.
  • The study highlights the importance of considering UDCA response in managing PBC, particularly in male populations and those with portal hypertension.
Abstract

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