Characterization of a Northern German Primary Biliary Cholangitis Cohort

Real-world data on risk stratification and clinical management of patients with primary biliary cholangitis (PBC) are limited. Identification of patients with increased risk for disease progression is, however, important, since they may benefit from more stringent treatment goals and second line therapy.

In this study, we retrospectively characterized a cohort of 535 PBC patients from a university hospital in northern Germany. We evaluated risk factors of disease progression, such as inadequate response to ursodeoxycholic acid (UDCA), younger age, vibration-controlled transient elastography (VCTE)-based evidence of progressed fibrosis, and co-morbidities (autoimmune hepatitis variant syndrome or obesity). The aim of this study was to get insights into the characteristics and risk factors of PBC patients which might contribute to an improved patient care.

PBC was mainly diagnosed in women (92%), aged between 50 and 69 years at the time of evaluation. The majority of PBC patients were overweight and 27% revealed obesity (BMI ≥ 30 kg/m²). PBC patients with autoimmune hepatitis variant syndrome (17% in our cohort) showed a similar treatment response to ursodeoxycholic acid (according to Paris II) compared to PBC patients without a variant syndrome (55% versus 57%). Patients younger than 50 years revealed a lower treatment response rate compared to older patients (40% versus 62%). Compared to patients without advanced fibrosis, PBC patients with advanced fibrosis (VCTE values ≥ 10 kPa) had a lower treatment response (65% versus 37%).

Identification of risk factors and hepatic co-morbidities is important to optimize the management and treatment of PBC patients.