The DOI matches its Crossref record; 277 of the 277 references it cites were found in a registry or an index; 62 of the 203 sources its claims cite were checked for support.
Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases
Open accessAbstract
AASLD practice guidance on diagnostic and therapeutic care of PBC.
Overview
Integrity signals
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Cites
Statistics
Verification
Claims the paper makes
61 No full text of the sources · 19 Partly supported · 18 No basis given · 15 Supported · 11 Not checked yet · 8 Sources not found · 6 Supported so far · 6 Own interpretation · 5 Couldn’t confirm · 4 Not supported · accuracy not yet measured
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“while the largest study found that only 8 of 1,476 patients with PBC later developed AIH.(120)”
What the sources say
- Disputedcites [120] 120. Gossard AA, Lindor KD. Development of autoimmune hepa- titis in primary biliary cirrhosis. Liver Int. 2007;27:1086-1090. 121 sourceExperimental — accuracy not yet measured
The Abstract and the ‘Frequency and Baseline Characteristics’ section report that 12 of 282 PBC patients developed AIH during follow-up, not 8 of 1,476. No page number is supplied for these passages in our copy. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“Serum ALP dropped by 53.9% in the 10-mg group, 37.2% in the 50-mg group, and by only 0.8% in the placebo group.(160)”
What the sources say
- Disputedcites [160] 160. Kowdley KV, Luketic V, Chapman R, Hirschfield GM, Poupon R, Schramm C, et al. A randomized trial of obeti- cholic acid monotherapy in patients with primary biliary chol- angitis. Hepatology. 2018;67:1890-1902. 161 sourceExperimental — accuracy not yet measured
The Trial Design section describes a phase 3 trial with placebo, 5–10-mg, and 10-mg groups, not a phase 2 study with a 50-mg group. The Secondary End Points section reports 12-month ALP reductions of 113, 130, and 14 U/L in those groups, respectively, rather than the claimed percentages. Page numbers were not available in our copy. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plaindirectn = 59- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“A phase 2 randomized controlled trial evaluated 3 doses of OCA (10 mg, 25 mg, and 50 mg) against placebo for 3 months in a study including 165 patients.(159) A 21% to 25% reduction in ALP was achieved in the OCA groups compared with 3% reduction in the placebo group.”
What the sources say
- Disputedcites [159] 159. Hirschfield GM, Mason A, Luketic V, Lindor K, Gordon SC, Mayo M, et al. Efficacy of obeticholic acid in patients with primary biliary cirrhosis and inadequate response to ursode- oxycholic acid. Gastroenterology. 2015;148:751-761:e8. 160 sourceExperimental — accuracy not yet measured
The Study Design and Abstract describe a three-month phase 2 randomized trial, but patients received 10 mg or 50 mg OCA—not 25 mg—and 59 patients were dosed, not 165. The Results (Primary Endpoint) report ALP reductions of 53.9% and 37.2% in the OCA groups versus 0.8% with placebo, contrary to the claimed 21%–25% versus 3%. Page numbers were not provided in our copy. (LLM, conf=0.94)
Checked by a reasoning model — may be wrong.
plaindirectn = 165- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
Every source the paper cites for this claim was checked and supports it.
In the paper
“The etiology of PBC is thought to be due to a combination of genetic risk factors and environmental triggers.(5)(6)(7)”
What the sources say
- Supportedcites [5] 5. Selmi C, Mayo MJ, Bach N, Ishibashi H, Invernizzi P, Gish G, et al. Primary biliary cirrhosis in monzygotic and dizygotic twins: Genetics, epigenetics, and environment. Gastroenterology. 2004;127:485-492. source
The opening section (p. 1) explicitly describes growing evidence that genetic susceptibility and environmental factors interact in PBC. The Discussion (p. 6) says the twin findings suggest a major genetic role and do not rule out environmental factors as triggers, consistent with the citing sentence’s qualified wording. (LLM, conf=0.94)
- Supportedcites [6] 6. Shin S, Moh IH, Woo YS, Jung SW, Kim JB, Park JW, et al. Evidence from a familial case suggests maternal inher- itance of primary biliary cholangitis. World J Gastroenterol. 2017;23:7191-7197. source
The Abstract describes environmental exposures interacting with the epigenome in genetically susceptible individuals. The ‘Epigenetics in Cholangiopathy’ section also reports genetic risk loci for PBC and environmental associations with PBC. Together, these support the citing sentence’s qualified account of its etiology; page numbers were not provided in our copy. (LLM, conf=0.90)
- Supportedcites [7] 7. Cheung AC, LaRusso NF, Gores GJ, Lazaridis KN. Epigenetics in the primary biliary cholangitis and primary sclerosing cholangitis. Semin Liver Dis. 2017;37:159-174. source
The cholangiopathy section reports genetic risk loci for PBC and environmental associations with its development, including smoking, recurrent urinary tract infections, and hair-dye use. The Abstract also describes an interplay between environmental exposures and the epigenome in genetically susceptible individuals. Together, these support the citing sentence’s qualified account of PBC etiology; page numbers were not provided in our copy. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“All of these studies provide evidence of progressive disease in a substantial proportion of patients, with between 36% and 89% becoming symptomatic during average follow-up periods ranging from 4.5 to 17.8 years and a median time from diagnosis to the appearance of symptoms between 2 and 4.2 years.”
What the sources say
- Not checked — no full text of the sourcecites [44] 44. Long RG, Scheuer PJ, Sherlock S. Presentation and course of asymptomatic primary biliary cirrhosis. Gastroenterology. 1977;72:1204-1207. source
- Not checked — no full text of the sourcecites [45] 45. Mahl TC, Shockcor W, Boyer JL. Primary biliary cirrhosis: survival of a large cohort of symptomatic and asymptomatic patients followed for 24 years. J Hepatol. 1994;20:707-713. source
- Partly supportedcites [46] 46. Mitchison HC, Lucey MR, Kelly PJ, Neuberger JM, Williams R, James OF. Symptom development and prognosis in primary biliary cirrhosis: a study in two centers. Gastroenterology. 1990;99:778-784. sourceExperimental — accuracy not yet measured
The Abstract reports that 19 of 70 patients at Freeman Hospital and 15 of 25 at King's College Hospital developed symptoms—34 of 95 patients, or about 36%. The Results give a median follow-up of 69 months for initially asymptomatic patients. This study supports the lower symptom-development figure, but does not itself report 89% or average follow-up spanning 4.5 to 17.8 years; those figures in the citing sentence refer to the studies collectively. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“AMA is a highly disease-specific autoantibody (8) that targets the lipoic acid present on the 2-oxo-acid dehydrogenase complexes located on the inner mitochondrial membrane.(9)”
What the sources say
- Not checked — no full text of the sourcecites [8] 8. Gershwin ME, Mackay IR, Sturgess A, Coppel RL. Identification and specificity of a cDNA encoding the 70 kd mitochondrial antigen recognized in primary biliary cirrhosis. J Immunol. 1987;138:3525-3531. source
- Partly supportedcites [9] 9. Moteki S, Leung PS, Dickson ER, Van Thiel DH, Galperin C, Buch T, et al. Epitope mapping and reactivity of autoantibodies to the E2 component of 2-oxoglutarate dehydrogenase complex in primary biliary cirrhosis using recombinant 2-oxoglutarate dehydrogenase complex. Hepatology. 1996;23:436-444. sourceExperimental — accuracy not yet measured
Citation (9) is attached to the targeting and location clause, not the disease-specificity clause cited to (8). The Abstract identifies E2 subunits of 2-oxo-acid dehydrogenase complexes as AMA targets, and the epitope-mapping discussion places a recognized epitope in OGDC-E2’s lipoic-acid-binding region. It does not establish that AMA targets lipoic acid itself or that the complexes are located on the inner mitochondrial membrane; the discussion also says lipoic acid’s presence did not affect antibody binding to BCOADC-E2. Page numbers are unavailable in our copy. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Environmental risks have been suggested by several large case-control cohort studies that have found associations with urinary tract infections, reproductive hormone replacement, nail polish, and past cigarette smoking.(22)(23)(24)”
What the sources say
- Partly supportedcites [22] 22. Lammert C, Nguyen DL, Juran BD, Schlicht E, Larsen JJ, Atkinson EJ, et al. Questionaire based assessment of risk factors for primary biliary cirrhosis. Dig Liver Dis. 2013;45:589-594. sourceExperimental — accuracy not yet measured
The Results (Medical History; Health, Lifestyle, and Environmental Exposures; page unavailable) associate multiple urinary tract infections and a history of regular cigarette smoking with PBC. The Results (Gynecologic and Reproductive History; page unavailable) report similar hormone-replacement-therapy use in cases and controls, and no passage found supports an association with nail polish. The source therefore supports only part of the list attributed to it. (LLM, conf=0.89)
- Supportedcites [23] 23. Prince MI, Ducker SJ, James OF. Case-control studies of risk factors for primary biliary cirrhosis in two United Kingdom populations. Gut. 2010;59:508-512. source
The Multivariable Results report significant associations between PBC and a history of urinary tract infection, smoking, hormone replacement therapy, and frequency of nail-polish use. The study compared 1,032 patients with PBC against matched controls; its Discussion cautions that the nail-polish association was small. (LLM, conf=0.94)
- Supportedcites [24] 24. Gershwin ME, Selmi C, Worman HJ, Gold EB, Watnik M, Utts J, et al. Risk factors and comorbidities in primary biliary cirrhosis: a controlled interview-based study of 1032 patients. Hepatology. 2005;42:1194-1202. source
The Multivariable Results report significant associations between PBC and a history of urinary tract infection, smoking, hormone replacement therapy use, and frequency of nail polish use. The study compares 1,032 patients with matched controls; the Discussion cautions that the nail-polish association is small. (LLM, conf=0.94)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Despite progress, only an estimated 15% of the variability of the disease has been accounted for by genetic studies.(21)”
What the sources say
- Partly supportedcites [21] 21. Liu JZ, Almarri MA, Gaffney DJ, Mells GF, Jostins L, Cordell HJ, et al. Dense fine-mapping study identifies new susceptibility loci for primary biliary cirrhosis. Nat Genet. 2012;44:1137-1141. sourceExperimental — accuracy not yet measured
The paper’s passage on HLA associations (indexed under Abstract; page unavailable) says the identified variants explain 16.2% of estimated PBC heritability, close to the cited 15%. It distinguishes that share of heritability from the share of total disease-liability variance: the SNPs and HLA types explain 4.9% and 1.4% of liability variance, respectively. The claim does not preserve that distinction. (LLM, conf=0.89)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Primary Biliary Cholangitis (PBC) is considered an autoimmune disease because of its hallmark serologic signature, antimitochondrial antibody (AMA), and specific bile duct pathology.”
What the sources say
- Supportedcites [1] 1. Beuers U, Gershwin ME, Gish RG, Invernizzi P, Jones DEJ, Lindor K, et al. Changing nomenclature for PBC: From 'cirrhosis' to 'cholangitis'. Clin Res Hepatol Gastroenterol. 2015;39:e57-e59. source
In the main text (page unavailable), the paper calls antimitochondrial antibodies PBC’s classic serologic hallmark and describes inflammatory damage to small bile ducts. It also groups PBC with immune-mediated biliary diseases, supporting the citing sentence’s characterization. (LLM, conf=0.89)
- Not matchedcites [2] 2. Eddy DM. A Manual for Assessing Health Practices and Designing Practice Policies: The Explicit Approach. Philadelphia, PA: American College of Physicians; 1992.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [3] 3. Selmi C, Bowlus CL, Gershwin ME, Coppel RL. Primary biliary cirrhosis. Lancet. 2011;377:1600-1609. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a large, international meta-analysis including 4,845 patients, UDCAtreated individuals had significantly improved transplant-free survival at 5, 10, and 15 years compared with nontreated individuals (90%, 78%, and 66% versus 79%, 59%, and 32%, respectively).(77)”
What the sources say
- Supportedcites [77] 77. Lammers WJ, van Buuren HR, Hirschfield GM, Janssen HL, Invernizzi P, Mason AL, et al. Levels of alkaline phosphatase and bilirubin are surrogate end points of outcomes of patients with primary biliary cirrhosis: an international follow-up study. Gastroenterology. 2014;147:1338-1349 e5; quiz e15. source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirectn = 4,845- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Histologically, AMA-negative PBC has been shown to have greater bile duct damage and loss compared with AMA-positive PBC.(117)(118)”
What the sources say
- Not matchedcites [117] 117. Taylor SL, Dean PJ, Riely CA. Primary autoimmune chol- angitis. An alternative to antimitochondrial antibody-negative primary biliary cirrhosis. Am J Surg Pathol. 1994;18:91-99. 118
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Supportedcites [118] 118. Jin Q , Moritoki Y, Lleo A, Tsuneyama K, Invernizzi P, Moritoki H, et al. Comparitivie analysis of portal cell infil- trates in antimitochondrial autoantibody-positive versus anti- mitochondrial autoantibody-negative primary biiary cirrhosis. Hepatology. 2012;55:1495-1506. 119 source
The Results (page unavailable) report significantly milder bile duct damage in AMA-positive than in AMA-negative PBC liver tissue. The comparison graded duct destruction using categories that included ductopenia (bile duct loss), supporting the histological comparison. (LLM, conf=0.90)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Some studies with extended follow-up have also shown improved survival.(59,62,63)”
What the sources say
- Supportedcites [59] 59. Lindor KD, Therneau TM, Jorgensen RA, Malinchoc M, Dickson ER. Effects of ursodeoxycholic acid on survival in patients with primary biliary cirrhosis. Gastroenterology. 1996;110:1515-1518. source
The Discussion reports long-term follow-up of patients with primary biliary cirrhosis treated with UDCA and says their transplantation-free survival exceeded that predicted by the Mayo risk score. This supports the claim of improved survival with extended follow-up, although the comparison was with predicted survival, not a placebo group. (LLM, conf=0.92)
- Not checked — no full text of the sourcecites [62] 62. Poupon RE, Poupon R, Balkau B. Ursodiol for the long-term treatment of primary biliary cirrhosis. The UDCA-PBC Study Group. N Engl J Med. 1994;330:1342-1347. source
- Partly supportedcites [63] 63. Poupon RE, Lindor KD, Cauch-Dudek K, Dickson ER, Poupon R, Heathcote EJ. Combined analysis of randomized controlled trials of ursodeoxycholic acid in primary biliary cir- rhosis. Gastroenterology. 1997;113:884-890. sourceExperimental — accuracy not yet measured
The Discussion reports that four years of UDCA increased survival free of liver transplantation in patients with primary biliary cirrhosis. That supports the extended-follow-up aspect, but the demonstrated outcome includes transplantation; the paper does not establish improved overall survival as the unqualified claim suggests. (LLM, conf=0.86)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Two studies have found that approximately 2.5% of PBC patients develop a subsequent acute AIH, (119,121)”
What the sources say
- Not checked — no full text of the sourcecites [119] 119. Efe C, Ozaslan E, Heurgue-Berlot A, Kav T, Masi C, Purnak T, et al. Sequential presentation of primary biliary cirrho- sis and autoimmune hepatitis. Eur J Gastroenterol Hepatol. 2014;26:532-537. 120 source
- Partly supportedcites [121] 121. Poupon R, Chazouilleres O, Corpechot C, Chretien Y. Development of autoimmune hepatitis in patients with typical primary biliary cirrhosis. Hepatology. 2006;44:85-90. 122 sourceExperimental — accuracy not yet measured
The Results section (“Frequency and Baseline Characteristics,” p. not available) reports that 12 of 282 PBC patients (4.3%) developed AIH during follow-up, supporting the subsequent-development point. It does not support the cited figure of approximately 2.5%, and the quoted passage does not characterize the subsequent AIH as acute. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“The open-label phase is still ongoing, but the reduction in ALP was sustained through the second year of the study.”
What the sources say
- Supportedcites [161] 161. Nevens F, Andreone P, Mazzella G, Strasser SI, Bowlus C, Invernizzi P, et al. A placebo-controlled trial of obeti- cholic acid in primary biliary cholangitis. N Engl J Med. 2016;375:631-643. 162 source
The Open-Label Extension section (p. 7) reports sustained reductions in alkaline phosphatase through two years of obeticholic acid treatment among patients who received it during the double-blind phase. The Trial Design section (p. 2) describes the extension as a five-year phase, consistent with it still being ongoing when the two-year results were reported. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Pruritus occurred more frequently in OCA-treated patients in a dose-dependent fashion.”
What the sources say
- Supportedcites [159] 159. Hirschfield GM, Mason A, Luketic V, Lindor K, Gordon SC, Mayo M, et al. Efficacy of obeticholic acid in patients with primary biliary cirrhosis and inadequate response to ursode- oxycholic acid. Gastroenterology. 2015;148:751-761:e8. 160 source
The Results (Safety Assessments; Table 3) report pruritus in 35% of placebo patients, 70% of patients receiving OCA 10 mg, and 94% receiving OCA 50 mg. The section explicitly states that its incidence was dose-dependent with OCA. (LLM, conf=0.95)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Improvements in other liver chemistries and inflammatory markers were also noted in OCA-treated patients.”
What the sources say
- Supportedcites [161] 161. Nevens F, Andreone P, Mazzella G, Strasser SI, Bowlus C, Invernizzi P, et al. A placebo-controlled trial of obeti- cholic acid in primary biliary cholangitis. N Engl J Med. 2016;375:631-643. 162 source
The Secondary End Points (p. 6) report significant decreases in several liver chemistries in the obeticholic acid groups compared with placebo. The same section reports a significant decrease in the inflammatory marker high-sensitivity CRP in both groups and in TNF-α in the 10-mg group. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Specifically, serum ALP and total bilirubin predict outcomes in this context.(77)”
What the sources say
- Supportedcites [77] 77. Lammers WJ, van Buuren HR, Hirschfield GM, Janssen HL, Invernizzi P, Mason AL, et al. Levels of alkaline phosphatase and bilirubin are surrogate end points of outcomes of patients with primary biliary cirrhosis: an international follow-up study. Gastroenterology. 2014;147:1338-1349 e5; quiz e15. source
The Discussion (p. 9) reports that alkaline phosphatase and bilirubin levels predict transplant-free survival in patients with PBC, with associations independent of UDCA use. The subgroup analysis (p. 7) specifically reports predictive results in UDCA-treated patients. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“About 20% of patients will have normalization of liver biochemistries after 2 years. (148)”
What the sources say
- Partly supportedcites [148] 148. Jorgensen RA, Dickson ER, Hofmann AF, Rossi SS, Lindor KD. Characterisation of patients with a complete biochemical response to ursodeoxycholic acid. Gut. 1995;36:935-938. 149 sourceExperimental — accuracy not yet measured
The Results report that 12 of 65 patients with PBC receiving ursodeoxycholic acid (19%) had normalized liver biochemical values after two years. This supports the approximate percentage and timing, but the claim omits the treatment condition and reads as applying to PBC patients generally. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Patients with high opioidergic tone may experience an opiate withdrawal-like reaction to opioid antagonists, characterized by abdominal pain, high blood pressure, tachycardia, goose bumps, nightmares, and depersonalization.(201)(202)(203)(204)”
What the sources say
- Not checked — no full text of the sourcecites [201] 201. Bergasa NV, Alling DW, Talbot TL, Swain MG, Yurdaydin C, Turner ML, et al. Effects of naloxone infusions in patients with the pruritus of cholestasis. A double-blind, randomized, controlled trial. Ann Intern Med. 1995;123:161-167. 202 source
- Partly supportedcites [202] 202. Thornton JR, Losowsky MS. Opioid peptides and primary biliary cirrhosis. BMJ. 1988;297:1501-1504. 203 sourceExperimental — accuracy not yet measured
The Discussion (p. 1502) describes an apparent withdrawal reaction after opioid antagonism in patients with raised opioid-peptide concentrations, including abdominal pain and increased arterial pressure. It explicitly says these patients had relative bradycardia, not tachycardia. The Results (p. 1502) do not report goose bumps, nightmares, or depersonalization. (LLM, conf=0.89)
- Partly supportedcites [203] 203. Bergasa NV, Alling DW, Talbot TL, Wells MC, Jones EA. Oral nalmefene therapy reduces scratching activity due to the pruritus of cholestasis: A controlled study. J Am Acad Dermatol. 1999;41:431-434. 204 sourceExperimental — accuracy not yet measured
The Discussion links increased opioidergic tone in cholestasis to antagonist-induced withdrawal-like reactions. The Duration of Nalmefene Therapy section reports abdominal pain or cramps, goose bumps, and depersonalization; Table 3 also lists nightmares. The copy does not report high blood pressure or tachycardia as features of these reactions. Page numbers were not provided for these passages. (LLM, conf=0.88)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Distal splenorenal shunts are rarely used but have not been associated with accelerated liver failure in patients with PBC.(237)”
What the sources say
- Supportedcites [237] 237. Boyer TD, Kokenes DD, Hertzler G, Kutner MH, Henderson JM. Effect of distal splenorenal shunt on sur- vival of patients with primary biliary cirrhosis. Hepatology. 1994;20:1482-1486. 238 source
The Discussion states that distal splenorenal shunting has minimal adverse effects on liver function and contrasts it with total shunts, which may hasten liver failure. The paper also reports that observed survival in 19 patients with PBC did not differ significantly from predicted survival. Its recommendation is chiefly for patients with well-preserved liver function. (LLM, conf=0.89)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Surveillance with regular imaging was associated with better clinical outcome of PBC patients who develop HCC.(227)(228)(229)(230)”
What the sources say
- Not checked — no full text of the sourcecites [227] 227. Jones DE, Metcalf JV, Collier JD, Bassendine MF, James OF. Hepatocellular carcinoma in primary biliary cirrhosis and its impact on outcomes. Hepatology. 1997;26:1138-1142. 228 source
- Partly supportedcites [228] 228. Nijhawan PK, Therneau TM, Dickson ER, Boynton J, Lindor KD. Incidence of cancer in primary biliary cirrhosis: the Mayo experience. Hepatology. 1999;29:1396-1398. 229 sourceExperimental — accuracy not yet measured
The Discussion recommends that PBC patients might benefit from more aggressive surveillance for hepatobiliary malignancies. It does not specify regular imaging or report that surveillance was associated with better outcomes among patients who developed HCC. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [229] 229. Suzuki A, Lymp J, Donlinger J, Mendes F, Angulo P, Lindor K. Clinical predictors for hepatocellular carcinoma in patients with primary biliary cirrhosis. Clin Gastroenterol Hepatol. 2007;5:259-2564. 230 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In patients identified as having osteoporosis, alendronate was shown in a randomized controlled trial to significantly improve bone density compared with placebo.”
What the sources say
- Partly supportedcites [239] 239. Guanabens N, Monegal A, Cerda D, Muxi A, Gifre L, Peris P, et al. Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with pri- mary biliary cirrhosis. Hepatology. 2013;58:2070-2078. 240 sourceExperimental — accuracy not yet measured
The Results report a significant increase in lumbar-spine bone mineral density from baseline with alendronate. But this randomized trial compared alendronate with ibandronate, not placebo, and studied postmenopausal women with primary biliary cirrhosis and osteoporosis. The claimed placebo comparison is therefore unsupported by this trial. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“monthly ibandronate was found comparable to weekly alendronate in safety and efficiency.(239)”
What the sources say
- Supportedcites [239] 239. Guanabens N, Monegal A, Cerda D, Muxi A, Gifre L, Peris P, et al. Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with pri- mary biliary cirrhosis. Hepatology. 2013;58:2070-2078. 240 source
The study summary reports similar gains in lumbar-spine bone mineral density and similar changes in bone markers with the two regimens. The Results report similar adverse-event rates, supporting comparable safety. These findings apply to the study’s postmenopausal women with primary biliary cirrhosis and osteoporosis; page numbers are not available in our copy. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“patients on UDCA post liver transplantation appear to have lower recurrence rates compared with patients who did not receive UDCA post transplant (21% versus 62%; P = 0.004).(257)”
What the sources say
- Could not verifycites [257] 257. Bosch A, Dumortier J, Maucort-Boulch D, Scoazec JY, Wendum D, Conti F, et al. Preventive administration of UDCA after liver transplantation for primary biliary cirrhosis is associated with a lower risk of disease recurrence. J Hepatol. 2015;63:1449-1458. 258 sourceExperimental — accuracy not yet measured
The Recurrence Rate and Conclusion sections report an overall histologic recurrence rate of 17%, but do not compare patients who did and did not receive UDCA. Searches for UDCA, ursodeoxycholic acid, and the claimed percentages and P value found no passage addressing the treatment comparison. (LLM, conf=0.75)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“In a recent study, a higher Model for End-Stage Liver Disease score at the time of wait list registration was also associated with increased recurrence rates.(257)”
What the sources say
- Could not verifycites [257] 257. Bosch A, Dumortier J, Maucort-Boulch D, Scoazec JY, Wendum D, Conti F, et al. Preventive administration of UDCA after liver transplantation for primary biliary cirrhosis is associated with a lower risk of disease recurrence. J Hepatol. 2015;63:1449-1458. 258 sourceExperimental — accuracy not yet measured
The Patient Groups and Conclusion sections describe the transplant cohort and estimate histologic PBC recurrence, but do not link recurrence to a MELD score at wait-list registration. Searches for “MELD,” “wait list registration,” and pretransplant disease severity found no passage addressing that association. (LLM, conf=0.72)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“retrospective studies suggest that there is no increased risk of cardiovascular disease in patients with PBC and hypercholesterolemia. (84,(244)(245)(246)”
What the sources say
- Not checked — no full text of the sourcecites [84] 84. Sorokin A, Brown JL, Thompson PD. Primary biliary cir- rhosis, hyperlipidemia, and atherosclerotic risk: a systematic review. Atherosclerosis. 2007;194:293-299. source
- Partly supportedcites [244] 244. Longo M, Crosignani A, Battezzati PM, Squarcia Giussani C, Invernizzi P, Zuin M, et al. Hyperlipidaemic state and cardiovascular risk in primary biliary cirrhosis. Gut. 2002;51:265-269. 245 sourceExperimental — accuracy not yet measured
The introduction says earlier retrospective studies did not demonstrate increased cardiovascular mortality in PBC, but they did not assess non-fatal events. The Abstract further distinguishes severe hypercholesterolaemia, which was not associated with excess cardiovascular risk, from moderate hypercholesterolaemia, which was associated with increased risk. The claim is therefore too broad for patients with PBC and hypercholesterolaemia as a whole. (LLM, conf=0.88)
- Supportedcites [245] 245. Allocca M, Crosignani A, Gritti A, Ghilardi G, Gobatti D, Caruso D, et al. Hypercholesterolaemia is not associated with early atherosclerotic lesions in primary biliary cirrhosis. Gut. 2006;55:1795-1800. 246 source
The introduction reports that studies of cardiovascular mortality in PBC suggested fatal events may not be increased, and that an evaluation of fatal and non-fatal events found no excess risk associated with hypercholesterolaemia. The Discussion explicitly says the paper's findings agree with earlier retrospective studies of cardiovascular morbidity and mortality in PBC. The citing sentence's 'suggest' reflects that qualified account. (LLM, conf=0.89)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Fortunately, recurrent PBC infrequently affects long-term patient or graft survival.(258)”
What the sources say
- Partly supportedcites [258] 258. Sylvestre PB, Batts KP, Burgart LJ, Poterucha JJ, Wiesner RH. Recurrence of primary biliary cirrhosis after liver trans- plantation: Histologic estimate of incidence and natural his- tory. Liver Transpl. 2003;9:1086-1093. 259 sourceExperimental — accuracy not yet measured
The Introduction says clinically recognized recurrent PBC has rarely been reported, and the Conclusion reports progression to septal fibrosis in only 2 of 17 patients with histologic recurrence. Those findings support limited observed clinical impact, but the paper does not establish an effect on long-term patient or graft survival; the Conclusion says longer follow-up is needed to assess clinical significance. (LLM, conf=0.78)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“The median time to recurrence is 3 to 6 years.(256,257)”
What the sources say
- Not checked — no full text of the sourcecites [256] 256. Duclos-Vallee JC, Sebagh M. Recurrence of autoimmune dis- ease, primary sclerosing cholangitis, primary biliary cirrhosis, and autoimmune hepatitis after liver transplantation. Liver Transpl. 2009;15(Suppl 2):S25-S34. 257 source
- Supportedcites [257] 257. Bosch A, Dumortier J, Maucort-Boulch D, Scoazec JY, Wendum D, Conti F, et al. Preventive administration of UDCA after liver transplantation for primary biliary cirrhosis is associated with a lower risk of disease recurrence. J Hepatol. 2015;63:1449-1458. 258 source
The Recurrence Rate section reports a median time to first histologic PBC recurrence of 3.1 years after transplantation, within the cited 3-to-6-year range. No page number is provided in our copy. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“a monthly regimen with ibandronate is associated with higher adherence compared with a weekly alendronate regimen”
What the sources say
- Supportedcites [239] 239. Guanabens N, Monegal A, Cerda D, Muxi A, Gifre L, Peris P, et al. Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with pri- mary biliary cirrhosis. Hepatology. 2013;58:2070-2078. 240 source
The Results report significantly higher adherence with monthly ibandronate than with weekly alendronate, measured by the Morisky-Green scale (P = 0.009). The trial studied postmenopausal women with primary biliary cirrhosis and osteoporosis. (LLM, conf=0.94)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
None of the sources cited for this claim have been checked yet.
In the paper
“The median time to develop extensive fibrosis (≥F3) was 2 years.”
What the sources say
- Not matchedcites [52] 52. Christensen E, Neuberger J, Crowe J, Altman DG, Popper H, Portmann B, et al. Beneficial effect of azathioprine and predic- tion of prognosis in primary biliary cirrhosis. Final results of an international trial. Gastroenterology. 1985;89:1084-1091.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [53] 53. Corpechot C, Carrat F, Bonnand AM, Poupon RE, Poupon R. The effect of ursodeoxycholic acid therapy on liver fibro- sis progression in primary biliary cirrhosis. Hepatology. 2000;32:1196-1199. source
- Not checked — no full text of the sourcecites [54] 54. Locke GR 3rd, Therneau TM, Ludwig J, Dickson ER, Lindor KD. Time course of histological progression in primary biliary cirrhosis. Hepatology. 1996;23:52-56. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“The prevalence of AMA positivity in first-degree relatives (FDRs) of PBC patients is increased compared with controls (13.1% and 1%, respectively).”
What the sources say
- Not checked — no full text of the sourcecites [43] 43. Lazaridis KN, Juran BD, Boe GM, Slusser JP, de Andrade M, Homburger HA, et al. Increased prevalence of antimito- chondrial antibodies in first-degree relatives of patients with primary biliary cirrhosis. Hepatology. 2007;46:785-792. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Histologic stages have been found to predict survival.(50,52)”
What the sources say
- Not checked — no full text of the sourcecites [50] 50. Roll J, Boyer JL, Barry D, Klatskin G. The prognostic im- portance of clinical and histologic features in asymptomatic and symptomatic primary biliary cirrhosis. N Engl J Med. 1983;308:1-7. source
- Not matchedcites [52] 52. Christensen E, Neuberger J, Crowe J, Altman DG, Popper H, Portmann B, et al. Beneficial effect of azathioprine and predic- tion of prognosis in primary biliary cirrhosis. Final results of an international trial. Gastroenterology. 1985;89:1084-1091.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“AMA is found in 95% of PBC patients.(85)”
What the sources say
- Not matchedcites [85] 85. Kaplan MM, Gershwin ME. Primary biliary cirrhosis. N Engl J Med. 2005;353:1261-1273.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“In the absence of ursodeoxycholic acid (UDCA) therapy, patients have a significantly shortened survival compared with a healthy population regardless of symptoms.(48)(49)”
What the sources say
- Not checked — no full text of the sourcecites [48] 48. Prince M, Chetwynd A, Newman W, Metcalf JV, James OF. Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis: follow-up for up to 28 years. Gastroenterology. 2002;123:1044-1051. source
- Not checked — no full text of the sourcecites [49] 49. Springer J, Cauch-Dudek K, O'Rourke K, Wanless IR, Heathcote EJ. Asymptomatic primary biliary cirrhosis: a study of its natural history and prognosis. Am J Gastroenterol. 1999;94:47-53. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients with AMA-positive PBC who respond biochemically to UDCA therapy may subsequently present with clinical features of AIH.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“A simplified AIH scoring system has more recently been developed, and, when applied to PBC patients, it identified fewer patients meeting probable AIH criteria than the older scoring system did (4% versus 12%).(125)(126)”
What the sources say
- Not checked — no full text of the sourcecites [125] 125. Neuhauser M, Bjornsson E, Treeprasertsuk S, Enders F, Silveira M, Talwalkar J, et al. Autoimmune hepatitis-PBC overlap syndrome: a simplified scoring system may assist in the diagnosis. Am J Gastroenterol. 2010;105:345-353. 126 source
- Not checked — no full text of the sourcecites [126] 126. Liu F, Pan ZG, Ye J, Xu D, Guo H, Li GP, et al. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: sim- plified criteria may be effective in the diagnosis in Chinese patients. J Dig Dis. 2014;15:660-668. 127 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“There are case reports of patients with overt AIH who nevertheless tested AMA positive, (138)(139) but on long-term follow-up, these patients do not develop PBC.(136,140)”
What the sources say
- Not checked — no full text of the sourcecites [138] 138. Farias AQ , Goncalves LL, Bittencourt PL, De Melo ES, Abrantes-Lemos CP, Porta G, et al. Applicability of the IAIHG scoring system to the diagnosis of antimitochondrial/ anti-M2 seropositive variant form of autoimmune hepatitis. J Gastroenterol Hepatol. 2006;21:887-893. 139 source
- Not checked — no full text of the sourcecites [139] 139. Nezu S, Tanaka A, Yasui H, Imamura M, Nakajima H, Ishida H, et al. Presence of antimitochondrial autoantibodies in pa- tients with autoimmune hepatitis. J Gastroenterol Hepatol. 2006;21:1448-1454. 140 source
- Not checked — no full text of the sourcecites [136] 136. O'Brien C, Joshi S, Feld JJ, Guindi M, Dienes HP, Heathcote EJ. Long-term follow-up of antimitochondrial antibody-posi- tive autoimmune hepatitis. Hepatology. 2008;48:550-556. 137 source
- Not checked — no full text of the sourcecites [140] 140. Muratori P, Efe C, Muratori L, Ozaslan E, Schiano T, Yoshida EM, et al. Clinical implications of antimitochondrial antibody seropositivity in autoimmune hepatitis: a multicentre study. Eur J Gastroenterol Hepatol. 2017;29:777-780. 141 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There are no randomized, controlled data that indicate how best to treat patients thought to have simultaneous PBC/AIH overlap.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In this case series, none of the 5 patients who tested positive for AMA (among 166 patients) had bile duct changes on examination of liver histology.”
What the sources say
- Not checked — no full text of the sourcecites [137] 137. Czaja AJ, Muratori P, Muratori L, Carpenter HA, Bianchi FB. Diagnostic and therapeutic implications of bile duct injury in autoimmune hepatitis. Liver Int. 2004;24:322-329. 138 source
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Twenty-six patients with PBC/AIH overlap who were followed for a mean of 5 to 6 years were compared to 135 patients with classic PBC.(134) This study indicated a worse outcome in terms of complications of portal hypertension, death, or need for liver transplant in patients with PBC and a probable or definite International Autoimmune Hepatitis Group score.”
What the sources say
- Not checked — no full text of the sourcecites [134] 134. Silveira MG, Talwalkar JA, Angulo P, Lindor KD. Overlap of autoimmune hepatitis and primary biliary cirrhosis: long-term outcomes. Am J Gastroenterol. 2007;102:1244-1250. 135 source
hedgedcorrelationaln = 6- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“There are few data on the prevalence of detectable serum AMA in patients who otherwise have typical features of AIH.(136)”
What the sources say
- Not checked — no full text of the sourcecites [136] 136. O'Brien C, Joshi S, Feld JJ, Guindi M, Dienes HP, Heathcote EJ. Long-term follow-up of antimitochondrial antibody-posi- tive autoimmune hepatitis. Hepatology. 2008;48:550-556. 137 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A short-term pharmacokinetic study of normal volunteers suggested substantial differences in bioavailability on the basis of preparation.(146)”
What the sources say
- Not checked — no full text of the sourcecites [146] 146. Williams CN, Al-Knawy B, Blanchard W. Bioavailability of four ursodeoxycholic acid preparations. Aliment Pharmacol Ther. 2000;14:1133-1139. 147 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Although studies examining the efficacy of OCA on survival of patients with PBC are still ongoing, data obtained through microsimulation models suggest that the use of a combination of UDCA and OCA could decrease the 15-year cumulative incidences of decompensated cirrhosis, hepatocellular carcinoma, liver transplants, and liver-related deaths.(162)”
What the sources say
- Not checked — no full text of the sourcecites [162] 162. Samur S, Klebanoff M, Banken R, Pratt DS, Chapman R, Ollendorf DA, et al. Long-term clinical impact and cost-ef- fectiveness of obeticholic acid for the treatment of primary biliary cholangitis. Hepatology. 2017;65:920-928. 163 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Fluoxetine, a selective serotonin reuptake inhibitor, also did not improve fatigue.(185)”
What the sources say
- Not checked — no full text of the sourcecites [185] 185. Talwalkar JA, Donlinger JJ, Gossard AA, Keach JC, Jorgensen RA, Petz JC, et al. Fluoxetine for the treatment of fatigue in primary biliary cirrhosis: a randomized, double-blind con- trolled trial. Dig Dis Sci. 2006;51:1985-1991. 186 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Furthermore, in September 2017, the Food and Drug Administration issued a warning regarding inappropriate dosing of OCA in patients with moderate to severe liver impairment (Child-Pugh-Turcotte B and C), which was associated with worsening PBC and death.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The benefit of OCA in patients with decompensated liver disease is not established.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Transient elastography can also be used to risk-stratify patients with PBC: in one study, those with a liver stiffness greater than 9.6 kPa were 5 times more likely to progress with clinical decompensation, death, or transplant.(80)”
What the sources say
- Not checked — no full text of the sourcecites [80] 80. Corpechot C, Carrat F, Poujol-Robert A, Gaouar F, Wendum D, Chazouilleres O, et al. Noninvasive elastography-based as- sessment of liver fibrosis progression and prognosis in primary biliary cirrhosis. Hepatology. 2012;56:198-208. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Patients on combination UDCA/ bezafibrate had substantial improvement in liver chemistries, with 67% normalizing ALP and 30% normalizing all liver tests compared with 0% treated with placebo.(94)”
What the sources say
- Not checked — no full text of the sourcecites [94] 94. Corpechot C, Chazouillères O, Rousseau A, Guyader D, Habersetzer F, Mathurin P, et al. A 2-year multicenter, double-blind, randomized, placebo-controlled study of be- zafibrate for the treatment of primary biliary cholangitis in patients with inadequate biochemical response to ursodeoxy- cholic acid therapy (Bezurso). J Hepatol. 2017;66:S89. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“When one of these binary definitions for response to UDCA is used, up to 40% of PBC patients will have an inadequate response to treatment.(150)”
What the sources say
- Not checked — no full text of the sourcecites [150] 150. Kuiper EM, Hansen BE, de Vries RA, den Ouden-Muller JW, van Ditzhuijsen TJ, Haagsma EB, et al. Improved prog- nosis of patients with primary biliary cirrhosis that have a bio- chemical response to ursodeoxycholic acid. Gastroenterology. 2009;136:1281-1287. 151 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Silymarin was tested in combination with UDCA but offered little additional benefit.(163)”
What the sources say
- Not matchedcites [163] 163. Kaplan MM, Cheng S, Price LL, Bonis PA. A randomized controlled trial of colchicine plus ursodiol versus methotrex- ate plus ursodiol in primary biliary cirrhosis: ten-year results. Hepatology. 2004;39:915-923. 164
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“A direct comparison of different drug formulations has not been studied in patients with PBC.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Other drugs have been tested, but none have been found as single agents to be of benefit.”
What the sources say
- Not matchedcites (52,(168)(169)(170)(171)(172)(173)(174)(175)(176)(177)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The studies that show an improvement in survival have all used this dose of 13 to 15 mg/kg/ day.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Through FXR activation, OCA modulates bile acid synthesis, absorption, transport, secretion, and metabolism, with a net effect of choleresis.(157,158)”
What the sources say
- Not checked — no full text of the sourcecites [157] 157. Thomas C, Pellicciari R, Pruzanski M, Auwerx J, Schoonjans K. Targeting bile-acid signalling for metabolic diseases. Nat Rev Drug Discov. 2008;7:678-693. 158 source
- Not checked — no full text of the sourcecites [158] 158. Beuers U, Trauner M, Jansen P, Poupon R. New paradigms in the treatment of hepatic cholestasis: from UDCA to FXR. PXR and beyond. J Hepatol. 2015;62(1 Suppl):S25-S37. 159 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Another study included 48 patients with an incomplete response to UDCA who received additional treatment with the pan-PPAR isoform bezafibrate 400 mg/day for a median of 38 months.Of these, 54% normalized their ALP levels within the first 4 months of treatment.(166)”
What the sources say
- Not checked — no full text of the sourcecites [166] 166. Reig A, Sese P, Pares A. Effects of bezafibrate on outcome and pruritus in primary biliary cholangitis with subopti- mal ursodeoxycholic acid response. Am J Gastroenterol. 2018;113:49-55. 167 source
plaindirectn = 48- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Importantly, most patients who had pruritus at baseline noted significant improvement while on bezafibrate.”
What the sources say
- Not checked — no full text of the sourcecites [166] 166. Reig A, Sese P, Pares A. Effects of bezafibrate on outcome and pruritus in primary biliary cholangitis with subopti- mal ursodeoxycholic acid response. Am J Gastroenterol. 2018;113:49-55. 167 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A study comparing three different doses of UDCA showed that a dose of 13 to 15 mg/kg/day appeared superior to either a lower dose of 5 to 7 mg/kg/day or a higher dose of 23 to 25 mg/kg/day in biochemical responses and cost.(145)”
What the sources say
- Not matchedcites [145] 145. Angulo P, Dickson ER, Therneau TM, Jorgensen RA, Smith C, DeSotel CK, et al. Comparison of three doses of ursode- oxycholic acid in the treatment of primary biliary cirrhosis: a randomized trial. J Hepatol. 1999;30:830-835. 146
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These scores identify patients who are at increased risk for progression to death or liver transplantation and who may benefit from adjuvant therapy.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In animal models, FXR activation has demonstrated antifibrotic and anti-inflammatory properties as well.(157)”
What the sources say
- Not checked — no full text of the sourcecites [157] 157. Thomas C, Pellicciari R, Pruzanski M, Auwerx J, Schoonjans K. Targeting bile-acid signalling for metabolic diseases. Nat Rev Drug Discov. 2008;7:678-693. 158 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Cholestyramine and other bile acid-binding sequestrants as well as some antacids may interfere with UDCA absorption.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“One study showed that 6% of patients with PBC without cirrhosis had varices.(91)”
What the sources say
- Not checked — no full text of the sourcecites [91] 91. Ali AH, Sinakos E, Silveira MG, Jorgensen RA, Angulo P, Lindor KD. Varices in early histological stage primary biliary cirrhosis. J Clin Gastroenterol. 2011;45:e66-e71. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Rifampicin, a pregnane X receptor agonist, has been used to successfully treat pruritus in patients with PBC in multiple small clinical trials at doses ranging from 150 mg daily to 300 mg twice daily.(193)(194)(195)(196)”
What the sources say
- Not checked — no full text of the sourcecites [193] 193. Hoensch HP, Balzer K, Dylewizc P, Kirch W, Goebell H, Ohnhaus EE. Effect of rifampicin treatment on hepatic drug metabolism and serum bile acids in patients with primary bil- iary cirrhosis. Eur J Clin Pharmacol. 1985;28:475-477. 194) source
- Not checked — no full text of the sourcecites [194] 194. Ghent CN, Carruthers SG. Treatment of pruritus in primary biliary cirrhosis with rifampin. Results of a double-blind, cross- over, randomized trial. Gastroenterology. 1988;94:488-493. 195 source
- Not checked — no full text of the sourcecites [195] 195. Bachs L, Pares A, Elena M, Piera C, Rodes J. Comparison of rifampicin with phenobarbitone for treatment of pruritus in biliary cirrhosis. Lancet. 1989;1:574-576. 196 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Two meta-analyses have reported that rifampicin administration is associated with relief of pruritus in cholestasis.(197,198)”
What the sources say
- Not checked — no full text of the sourcecites [197] 197. Tandon P, Rowe BH, Vandermeer B, Bain VG. The efficacy and safety of bile Acid binding agents, opioid antagonists, or rifampin in the treatment of cholestasis-associated pruritus. Am J Gastroenterol. 2007;102:1528-1536. 198 source
- Not checked — no full text of the sourcecites [198] 198. Khurana S, Singh P. Rifampin is safe for treatment of pruritus due to chronic cholestasis: a meta-analysis of prospective ran- domized-controlled trials. Liver Int. 2006;26:943-948. 199 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Patients with fibrotic PBC have a significantly greater risk of osteopenia and osteoporosis than do age-matched and sex-matched controls.(238)”
What the sources say
- Not checked — no full text of the sourcecites [238] 238. Menon KV, Angulo P, Weston S, Dickson ER, Lindor KD. Bone disease in primary biliary cirrhosis: indepen- dent indicators and rate of progression. J Hepatol. 2001;35: 316-323. 239 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The value of screening family members has not been firmly established; however, screening is usually recommended for female FDRs beginning at age 30.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Long-term use of opiate antagonists has been associated with lowering of the pain threshold and unmasking of chronic pains.(206)”
What the sources say
- Not checked — no full text of the sourcecites [206] 206. McRae CA, Prince MI, Hudson M, Day CP, James OFW, Jones DEJ. Pain as a complication of use of opiate antago- nists for symptom control in cholestasis. Gastroenterology. 2003;125:591-596. 207 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Intractable pruritus can be a valid indication for liver transplantation.(219,220)”
What the sources say
- Not matchedcites [219] 219. Elias E. Liver transplantation. J R Coll Physicians Lond. 1993;27:224-232. 220
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [220] 220. Neuberger J, Jones EA. Liver transplantation for intrac- table pruritus is contraindicated before an adequate trial of opiate antagonist therapy. Eur J Gastroenterol Hepatol. 2001;13:1393-1394. 221 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Another study suggests that varices are virtually never found unless the Mayo risk score is at least 4.1.(78)”
What the sources say
- Not matchedcites [78] 78. Angulo P, Lindor KD, Therneau TM, Jorgensen RA, Malinchoc M, Kamath PS, et al. Utilization of the Mayo risk score in patients with primary biliary cirrhosis receiving ur- sodeoxycholic acid. Liver. 1999;19:115-121.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“although treatment with UDCA did not change the risk overall.”
What the sources say
- Not checked — no full text of the sourcecites [226] 226. Trivedi PJ, Bruns T, Cheung A, Li KK, Kittler C, Kumagi T, et al. Optimising risk stratification in primary biliary cirrhosis: AST/platelet ratio index predicts outcome in- dependent of ursodeoxycholic acid response. J Hepatol. 2014;60:1249-1258. 227 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“UDCA should be continued indefinitely; data regarding long-term OCA are lacking.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Nevertheless, case series have reported efficacy using plasmapheresis, albumin dialysis, molecular adsorbent recirculating system, nasobiliary or external biliary drainage, and light therapy.(216)(217)(218)”
What the sources say
- Not checked — no full text of the sourcecites [216] 216. Pares A, Cisneros L, Salmeron JM, Caballeria L, Mas A, Torras A, et al. Extracorporeal albumin dialysis: a procedure for prolonged relief of intractable pruritus in patients with pri- mary biliary cirrhosis. Am J Gastroenterol. 2004;99:1105-1110. 217 source
- Not checked — no full text of the sourcecites [217] 217. Rifai K, Hafer C, Rosenau J, Athmann C, Haller H, Peter Manns M, et al. Treatment of severe refractory pruritus with fractionated plasma separation and adsorption (Prometheus). Scand J Gastroenterol. 2006;41:1212-1217. 218 source
- Not checked — no full text of the sourcecites [218] 218. Pusl T, Denk GU, Parhofer KG, Beuers U. Plasma separation and anion adsorption transiently relieve intractable pruritus in primary biliary cirrhosis. J Hepatol. 2006;45:887-891. 219 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Suboptimal response to UDCA was an important risk factor, (226)”
What the sources say
- Not checked — no full text of the sourcecites [226] 226. Trivedi PJ, Bruns T, Cheung A, Li KK, Kittler C, Kumagi T, et al. Optimising risk stratification in primary biliary cirrhosis: AST/platelet ratio index predicts outcome in- dependent of ursodeoxycholic acid response. J Hepatol. 2014;60:1249-1258. 227 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Family members of patients with PBC are at increased risk of developing the disease, particularly among female FDRs, including sisters and daughters.(43)”
What the sources say
- Not checked — no full text of the sourcecites [43] 43. Lazaridis KN, Juran BD, Boe GM, Slusser JP, de Andrade M, Homburger HA, et al. Increased prevalence of antimito- chondrial antibodies in first-degree relatives of patients with primary biliary cirrhosis. Hepatology. 2007;46:785-792. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Placebo itself is effective in ameliorating pruritus by about 20% to 40% in clinical trials, so results of uncontrolled trials should be interpreted with extreme caution.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The meta-analysis concluded that opiate antagonists are significantly more likely to decrease pruritus compared with placebo.”
What the sources say
- Not checked — no full text of the sourcecites [197] 197. Tandon P, Rowe BH, Vandermeer B, Bain VG. The efficacy and safety of bile Acid binding agents, opioid antagonists, or rifampin in the treatment of cholestasis-associated pruritus. Am J Gastroenterol. 2007;102:1528-1536. 198 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) appear to be safe even if serum liver tests are abnormal, (249)”
What the sources say
- Not matchedcites [249] 249. Chalasani N. Statins and hepatotoxicity: focus on patients with fatty liver. Hepatology. 2005;41:690-695. 250
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Alendronate is a more effective treatment than etidronate, (255)”
What the sources say
- Not checked — no full text of the sourcecites [255] 255. Baldo-Enzi G, Baiocchi MR, Grotto M, Floreani AR, Zagolin M, Chiaramonte M, et al. Lipoprotein pattern and plasma lipo- protein lipase activities in patients with primary biliary cirrhosis. Relationship with increase of HDL2 fraction in Lp-X-positive and Lp-X-negative subjects. Dig Dis Sci. 1988;33:1201-1207. 256 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“but there are no studies to confirm the longterm efficacy of any treatment.”
What the sources say
- Not checked — no full text of the sourcecites [255] 255. Baldo-Enzi G, Baiocchi MR, Grotto M, Floreani AR, Zagolin M, Chiaramonte M, et al. Lipoprotein pattern and plasma lipo- protein lipase activities in patients with primary biliary cirrhosis. Relationship with increase of HDL2 fraction in Lp-X-positive and Lp-X-negative subjects. Dig Dis Sci. 1988;33:1201-1207. 256 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In a more recent study querying the United Network for Organ Sharing database, the frequency of liver transplantation for PBC was again noted to be decreasing.(253)”
What the sources say
- Not checked — no full text of the sourcecites [253] 253. Singal AK, Guturu P, Hmoud B, Kuo YF, Salameh H, Wiesner RH. Evolving frequency and outcomes of liver trans- plantation based on etiology of liver disease. Transplantation. 2013;95:755-760. 254 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“and fibrates have been used safely.(250,251)”
What the sources say
- Not checked — no full text of the sourcecites [250] 250. Nakamuta M, Enjoji M, Kotoh K, Shimohashi N, Tanabe Y. Long-term fibrate treatment for PBC. J Gastroenterol. 2005;40:546-547. 251 source
- Not matchedcites [251] 251. Schaffner F. Paradoxical elevation of serum cholesterol by clofibrate in patients with primary biliary cirrhosis. Gastroenterology. 1969;57:253-255. 252
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The outcome of liver transplantation for patients with PBC is more favorable than for nearly all other disease categories.”
What the sources say
- Not checked — no full text of the sourcecites [253] 253. Singal AK, Guturu P, Hmoud B, Kuo YF, Salameh H, Wiesner RH. Evolving frequency and outcomes of liver trans- plantation based on etiology of liver disease. Transplantation. 2013;95:755-760. 254 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 60
- Probably not a substantial claim. 16
- The quote only partly states this claim. 1
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“Again, pruritus was the most important adverse event, leading to discontinuation of 38% of study subjects in the 50-mg arm.”
What the sources say
- Disputedcites [160] 160. Kowdley KV, Luketic V, Chapman R, Hirschfield GM, Poupon R, Schramm C, et al. A randomized trial of obeti- cholic acid monotherapy in patients with primary biliary chol- angitis. Hepatology. 2018;67:1890-1902. 161 sourceExperimental — accuracy not yet measured
The Safety and Side Effects section confirms that pruritus was the most common adverse event, but reports discontinuation due to pruritus in 10% of the 10-mg group and 1% of the 5–10-mg group. This trial had no 50-mg arm; the 38% figure is the incidence of pruritus in the placebo group, not a discontinuation rate. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Disputed
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“The indirect immunofluorescence method has the lowest sensitivity, with over 15% of AMA-negative sera by indirect immunofluorescence showing reactivity to MIT3, a combination of three mitochondrial antigens.(87)”
What the sources say
- Could not verifycites [87] 87. Bizzaro N, Covini G, Rosina F, Muratori P, Tonutti E, Villalta D, et al. Overcoming a "probable" diagnosis in antimitochon- drial antibody negative primary biliary cirrhosis: study of 100 sera and review of the literature. Clin Rev Allergy Immunol. 2012;42:288-297. sourceExperimental — accuracy not yet measured
The indexed copy contains an IRIS repository listing and a PDF link, but no passage from the paper addressing assay sensitivity. Searches for MIT3, indirect immunofluorescence, and the claimed 15% figure found no relevant passage, so the claim cannot be checked against our copy. (LLM, conf=0.76)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
Every source the paper cites for this claim was checked and supports it.
In the paper
“The GLOBE score was developed from a retrospective cohort of 2,488 UDCA-treated patients and validated by a second cohort of 1,631 European and North American patients.(74)”
What the sources say
- Supportedcites [74] 74. Lammers WJ, Hirschfield GM, Corpechot C, Nevens F, Lindor KD, Janssen HL, et al. Development and validation of a scoring system to predict outcomes of patients with pri- mary biliary cirrhosis receiving ursodeoxycholic acid therapy. Gastroenterology. 2015;149:1804-1812:e4. source
Statistical Analysis reports a derivation cohort of 2,488 patients and a separate validation cohort of 1,631, randomly split from the study population. Study Population and Design identifies the participants as UDCA-treated patients drawn from centers in North America and Europe. The validation cohort was a second group from the same database, not an independently recruited cohort. (LLM, conf=0.91)
plainn = 2,488- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“In addition to the high concordance among monozygotic twins compared with dizygotic twins with PBC (5) , the strong association with human leukocyte antigen alleles, which vary by ethnicity, supports a genetic cause of inherited risk.(12)(13)(14)(15)(16)(17)(18)(19)(20)”
What the sources say
- Supportedcites [5] 5. Selmi C, Mayo MJ, Bach N, Ishibashi H, Invernizzi P, Gish G, et al. Primary biliary cirrhosis in monzygotic and dizygotic twins: Genetics, epigenetics, and environment. Gastroenterology. 2004;127:485-492. source
The Results (p. 1) report PBC concordance in five of eight monozygotic twin pairs and none of eight dizygotic pairs; the Discussion (p. 6) says this suggests a major genetic role. In the citing sentence, this paper is citation (5) for the twin comparison. The HLA assertion has separate citations and is not attributed to this source. (LLM, conf=0.94)
- Supportedcites [12] 12. Juran BD, Hirshfield GM, Invernizzi P, Atkinson EJ, Li Y, Xie G, et al. Immunochip analyses identify a novel risk locus for primary biliary cirrhosis at 13q1, multiple independent associ- ations at four established risk loci and epistasis between 1p31 and 7q32 risk variants. Hum Mol Genet. 2012;21:5209-5221. source
The citation to this paper is attached to the HLA portion of the sentence, not the twin-concordance statement, which has a separate citation. In “Identification of multiple independent association signals at four PBC risk loci” (p. 5), the paper reports strong HLA class II allele associations with PBC and substantial allele-frequency differences between its Italian and Canadian/US cohorts. It says the associations’ direction and magnitude were generally consistent across those cohorts. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [13] 13. Johnson PJ, Qin S, Park JW, Poon RTP, Raoul JL, Philip PA, et al. Brivanib versus sorafenib as first-line therapy in patients with unresectable, advanced hepatocellular carcinoma: re- sults from the randomized phase III BRISK-FL study. J Clin Oncol. 2013;31:3517-3524. source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Although AMA-negative PBC patients are nearly identical to AMA-positive PBC patients, minor differences have been noted, including a higher prevalence of antinuclear and anti-smooth muscle antibodies and lower serum IgM levels.(111)(112)(113)”
What the sources say
- Supportedcites [111] 111. Lacerda MA, Ludwig J, Dickson ER, Jorgensen RA, Lindor KD. Antimitochondrial antibody-negative primary biliary cirrhosis. Am J Gastroenterol. 1995;90:247-249. 112 source
The discussion passage under “PBC=primary biliary cirrhosis” states that AMA-all negative patients were more likely than controls to have antinuclear and smooth muscle antibodies and had lower serum IgM. The Results passage also reports higher antibody prevalence in the AMA-negative group. Page numbers are not provided for these passages. (LLM, conf=0.94)
- Supportedcites [112] 112. Michieletti P, Wanless IR, Katz A, Scheuer PJ, Yeaman SJ, Bassendine MF, et al. Antimitochondrial antibody negative primary biliary cirrhosis: a distinct syndrome of autoimmune cholangitis. Gut. 1994;35:260-265. 113 source
The paper’s discussion states that, compared with AMA-positive controls, AMA-all-negative patients were more likely to have antinuclear and smooth muscle antibodies and had lower serum IgM concentrations. The Results section also reports higher antibody prevalence in the AMA-negative group. (LLM, conf=0.94)
- Not checked — no full text of the sourcecites [113] 113. Invernizzi P, Crosignani A, Battezzati PM, Covini G, De Valle G, Larghi A, et al. Comparison of the clinical fea- tures and clinical course of antimitochondrial antibody-pos- itive and -negative primary biliary cirrhosis. Hepatology. 1997;25:1090-1095. 114 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A number of studies have shown the benefit of UDCA in this context.(58)(59)(60)(61)(62)(63) Individual studies have demonstrated consistent evidence of improved liver biochemistries.”
What the sources say
- Supportedcites [58] 58. Heathcote EJ, Cauch-Dudek K, Walker V, Bailey RJ, Blendis LM, Ghent CN, et al. The Canadian Multicenter Double- blind Randomized Controlled Trial of ursodeoxycholic acid in primary biliary cirrhosis. Hepatology. 1994;19:1149-1156. sourceExperimental — accuracy not yet measured
The introductory passage indexed under Materials and Methods (page unavailable) describes several randomized trials of UDCA in PBC and reports biochemical improvement. A later passage indexed under Additional information (page unavailable) says longer-term follow-up studies found that improvements in liver biochemistries could be sustained. (LLM, conf=0.88)
- Supportedcites [59] 59. Lindor KD, Therneau TM, Jorgensen RA, Malinchoc M, Dickson ER. Effects of ursodeoxycholic acid on survival in patients with primary biliary cirrhosis. Gastroenterology. 1996;110:1515-1518. sourceExperimental — accuracy not yet measured
The paper’s opening section reports that multiple UDCA trials in patients with PBC found improvements in biochemical measures of cholestasis. The Discussion likewise describes favorable biochemical effects across published trials, while noting that individual patients’ responses vary. (LLM, conf=0.91)
- Supportedcites [60] 60. Pares A, Caballeria L, Rodes J. Excellent long-term survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic Acid. Gastroenterology. 2006;130:715-720. source
The opening passage reports that several UDCA trials in patients with PBC, including six large trials, all found improvement in biochemical cholestasis. The Discussion likewise says most published trials found favorable effects on biochemical parameters, while distinguishing these from less certain survival benefits. (LLM, conf=0.92)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Fatigue is the most common symptom in PBC; it has been found in 50% to 78% of patients and has a significant negative impact on quality of life.(95)(96)”
What the sources say
- Partly supportedcites [95] 95. Newton JLJD. Modafinil is effective treatment for excessive daytime somnolence and fatigue in primary biliary cirrhosis [Abstract]. Hepatology. 2006;44:628A. sourceExperimental — accuracy not yet measured
The Associations Between NHP Scores and the Characteristics of PBC section reports a significant association between fatigue and worse overall quality of life. The Discussion says fatigue was the finding most often associated with quality-of-life subscores, not that it was the most common symptom; it gives a prevalence range of 8%–80% across prior studies, not 50%–78%. Page numbers are unavailable in our copy. (LLM, conf=0.88)
- Partly supportedcites [96] 96. Poupon RE, Chretien Y, Chazouilleres O, Poupon R, Chwalow J. Quality of life in patients with primary biliary cir- rhosis. Hepatology. 2004;40:489-494. sourceExperimental — accuracy not yet measured
The Associations Between NHP Scores and the Characteristics of PBC section reports a significant association between fatigue and worse overall quality of life. The Discussion calls fatigue the finding most often associated with quality-of-life scores, not the most common symptom, and reports prevalence across prior studies as 8%–80%, not 50%–78%. Page numbers are unavailable in our copy. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“A PBC/AIH overlap syndrome may also refer to patients with PBC followed sequentially by AIH or, less commonly, AIH followed by PBC.(119)(120)(121)”
What the sources say
- Not checked — no full text of the sourcecites [119] 119. Efe C, Ozaslan E, Heurgue-Berlot A, Kav T, Masi C, Purnak T, et al. Sequential presentation of primary biliary cirrho- sis and autoimmune hepatitis. Eur J Gastroenterol Hepatol. 2014;26:532-537. 120 source
- Supportedcites [120] 120. Gossard AA, Lindor KD. Development of autoimmune hepa- titis in primary biliary cirrhosis. Liver Int. 2007;27:1086-1090. 121 source
The Frequency and Baseline Characteristics section identifies both sequential forms of PBC-AIH overlap syndrome: 12 patients developed AIH after PBC, while 5 developed PBC after AIH. The smaller second group supports the claim that AIH followed by PBC was less common in this cohort. (LLM, conf=0.94)
- Supportedcites [121] 121. Poupon R, Chazouilleres O, Corpechot C, Chretien Y. Development of autoimmune hepatitis in patients with typical primary biliary cirrhosis. Hepatology. 2006;44:85-90. 122 source
The Results section (“Frequency and Baseline Characteristics”) includes sequential cases under PBC-AIH overlap syndrome: 12 patients developed AIH after PBC, while 5 developed PBC after AIH. This supports both sequences and the claim that the latter was less common in this cohort; page numbers were not supplied in our copy. (LLM, conf=0.94)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
Every source the paper cites for this claim was checked and supports it.
In the paper
“The symptoms of PBC significantly impair quality of life (182) and do not typically improve with UDCA or OCA treatment.”
What the sources say
- Supportedcites [182] 182. Mells GF, Pells G, Newton JL, Bathgate AJ, Burroughs AK, Heneghan MA, et al. Impact of primary biliary cirrho- sis on perceived quality of life: the UK-PBC national study. Hepatology. 2013;58:273-283. 183 source
Citation (182) is attached to the claim that PBC symptoms significantly impair quality of life, not to the subsequent treatment claim. The Results report substantial quality-of-life impairment among PBC patients, and the Discussion says symptoms often had a dramatic impact on life quality. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Doubling the dose of UDCA and adding colchicine, methotrexate, or silymarin have not been found to be of benefit over and beyond that achieved with UDCA alone.(163,178,179)”
What the sources say
- Not matchedcites [163] 163. Kaplan MM, Cheng S, Price LL, Bonis PA. A randomized controlled trial of colchicine plus ursodiol versus methotrex- ate plus ursodiol in primary biliary cirrhosis: ten-year results. Hepatology. 2004;39:915-923. 164
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [178] 178. Angulo P, Patel T, Jorgensen RA, Therneau TM, Lindor KD. Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid. Hepatology. 2000;32:897-900. 179 source
- Partly supportedcites [179] 179. Angulo P, Jorgensen RA, Lindor KD. Incomplete response to ursodeoxycholic acid in primary biliary cirrhosis: is a double dosage worthwhile? Am J Gastroenterol. 2001;96:3152-3157. 180 sourceExperimental — accuracy not yet measured
The Discussion (page not specified) says adding colchicine showed no benefit for patients with a suboptimal response to UDCA. It also reports negative results from larger controlled trials of methotrexate, while acknowledging biochemical improvement in a few selected patients. Our copy does not establish the claimed lack of benefit from doubling the UDCA dose or adding silymarin. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, patients with earlier histologic stage usually respond more favorably to UDCA than patients with advanced disease, although patients with advanced disease may benefit in survival or avoid liver transplantation with this therapy.(63)”
What the sources say
- Partly supportedcites [63] 63. Poupon RE, Lindor KD, Cauch-Dudek K, Dickson ER, Poupon R, Heathcote EJ. Combined analysis of randomized controlled trials of ursodeoxycholic acid in primary biliary cir- rhosis. Gastroenterology. 1997;113:884-890. sourceExperimental — accuracy not yet measured
The Discussion suggests UDCA might be less efficacious when introduced later in disease, but does not establish that earlier histologic stages usually respond more favorably. For the outcome this study measured, survival free of transplantation, the subgroup analysis found a significant benefit at stage IV but not at stages I–II or III (Figure 3, Discussion). The claim that patients with advanced disease may benefit is supported. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“As with the phase 2 studies, pruritus was the most common adverse event, but it was less common in patients undergoing dose titration starting at 5 mg/day.”
What the sources say
- Supportedcites [161] 161. Nevens F, Andreone P, Mazzella G, Strasser SI, Bowlus C, Invernizzi P, et al. A placebo-controlled trial of obeti- cholic acid in primary biliary cholangitis. N Engl J Med. 2016;375:631-643. 162 source
The Trial Design section (p. 2) identifies this as a phase 3 trial and says the 5–10 mg group started at 5 mg daily, with an increase to 10 mg if appropriate. The Discussion (p. 10) calls pruritus the most common adverse event and reports a lower incidence in that group (56%) than in the group starting at 10 mg (68%). (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“After 1 year, this primary endpoint was met by 46% of patients in the titration group, 47% in the 10 mg/day group, and 10% of patients in the placebo group.(161)”
What the sources say
- Supportedcites [161] 161. Nevens F, Andreone P, Mazzella G, Strasser SI, Bowlus C, Invernizzi P, et al. A placebo-controlled trial of obeti- cholic acid in primary biliary cholangitis. N Engl J Med. 2016;375:631-643. 162 source
The Primary End Point section (p. 4) reports that at month 12 the endpoint was met by 46% in the 5–10-mg titration group, 47% in the 10-mg group, and 10% in the placebo group. These are the figures and time point attributed to the source in the citing sentence. (LLM, conf=0.95)
plainn = 210- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“However, UDCA therapy does not improve fatigue, pruritus, associated bone disease, or autoimmune features found in association with PBC.(69,89,153,154)”
What the sources say
- Not checked — no full text of the sourcecites [69] 69. Lindor KD, Jorgensen RA, Therneau TM, Malinchoc M, Dickson ER. Ursodeoxycholic acid delays the onset of esoph- ageal varices in primary biliary cirrhosis. Mayo Clin Proc. 1997;72:1137-1140. source
- Could not verifycites [89] 89. Degott C, Zafrani ES, Callard P, Balkau B, Poupon RE, Poupon R. Histopathological study of primary biliary cirrhosis and the effect of ursodeoxycholic acid treatment on histology progression. Hepatology. 1999;29:1007-1012. sourceExperimental — accuracy not yet measured
The paper’s ‘Effect of UDCA Therapy on Histological Progression’ and ‘UDCA Therapy and Histology Progression’ sections assess liver-biopsy findings, not whether UDCA improves fatigue, pruritus, bone disease, or associated autoimmune features. Searches for those symptoms and conditions found no passage addressing the claimed lack of improvement; page numbers were not supplied for the passages. (LLM, conf=0.75)
- Not checked — no full text of the sourcecites [153] 153. Balan V, Dickson ER, Jorgensen RA, Lindor KD. Effect of ursodeoxycholic acid on serum lipids of patients with primary biliary cirrhosis. Mayo Clin Proc. 1994;69:923-929. 154 source
- Not matchedcites [154] 154. Lindor KD, Janes CH, Crippin JS, Jorgensen RA, Dickson ER. Bone disease in primary biliary cirrhosis: Does ursodeoxy- cholic acid make a difference? Hepatology. 1995;21:389-392. 155
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although uncommon, drug-induced liver injuries-sometimes progressing to acute liver failure, hemolysis, renal impairment, and alteration in drug metabolism-have all been reported with rifampicin use such that use is avoided in patients with bilirubin levels greater than 2.5 mg/dL, with close follow-up warranted.(195,199)”
What the sources say
- Not checked — no full text of the sourcecites [195] 195. Bachs L, Pares A, Elena M, Piera C, Rodes J. Comparison of rifampicin with phenobarbitone for treatment of pruritus in biliary cirrhosis. Lancet. 1989;1:574-576. 196 source
- Partly supportedcites [199] 199. Prince MI, Burt AD, Jones DE. Hepatitis and liver dysfunc- tion with rifampicin therapy for pruritus in primary biliary cirrhosis. Gut. 2002;50:436-439. 200 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Etidronate was ineffective compared with placebo”
What the sources say
- Could not verifycites [239] 239. Guanabens N, Monegal A, Cerda D, Muxi A, Gifre L, Peris P, et al. Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with pri- mary biliary cirrhosis. Hepatology. 2013;58:2070-2078. 240 sourceExperimental — accuracy not yet measured
The introduction mentions trials of etidronate in patients with primary biliary cirrhosis, including bisphosphonate comparisons with placebo, but gives no result for etidronate versus placebo. The Results report outcomes for ibandronate and alendronate only. Searches for etidronate’s effectiveness versus placebo found no passage establishing the claimed lack of benefit. (LLM, conf=0.74)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although the itch in cholestasis does not appear to be histamine-related, antihistamines may be beneficial in patients with cholestasis, probably because of their sedative properties.(214,215)”
What the sources say
- Partly supportedcites [214] 214. Rishe E, Azarm A, Bergasa NV. Itch in primary bili- ary cirrhosis: a patients' perspective. Acta Derm Venereol. 2008;88:34-37. 215) sourceExperimental — accuracy not yet measured
The indexed Abstract (page unavailable) reports that patients with primary biliary cirrhosis most commonly associated antihistamines with itch relief. It does not establish that cholestatic itch is unrelated to histamine or attribute the reported relief to antihistamines’ sedative properties. (LLM, conf=0.84)
- Not matchedcites [215] 215. Greaves MW. Antihistamines in dermatology. Skin Pharmacol Physiol. 2005;18:220-229. 216
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“This helps detect patients who are inadequate responders to UDCA after 12 months of therapy, lack of adherence, and the rare patients who go on to develop AIH.(121,135,224,225)”
What the sources say
- Supportedcites [121] 121. Poupon R, Chazouilleres O, Corpechot C, Chretien Y. Development of autoimmune hepatitis in patients with typical primary biliary cirrhosis. Hepatology. 2006;44:85-90. 122 source
This source supports the AIH portion of the multiply cited sentence. In the Results (pp. 85–90), 12 of 282 patients with PBC developed AIH during follow-up; the Clinical and Laboratory Assessments section describes examinations at follow-up visits, and the Discussion cautions that the condition should not be missed. The paper does not establish the separate claims about 12-month UDCA response or adherence. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [135] 135. Chazouilleres O, Wendum D, Serfaty L, Rosmorduc O, Poupon R. Long term outcome and response to therapy of primary biliary cirrhosis-autoimmune hepatitis overlap syn- drome. J Hepatol. 2006;44:400-406. 136 source
- Not checked — no full text of the sourcecites [224] 224. Colombato LA, Alvarez F, Cote J, Huet PM. Autoimmune cholangiopathy: the result of consecutive primary bili- ary cirrhosis and autoimmune hepatitis? Gastroenterology. 1994;107:1839-1843. 225 source
- Not checked — no full text of the sourcecites [225] 225. Weyman RL, Voigt M. Consecutive occurrence of primary biliary cirrhosis and autoimmune hepatitis: a case report and review of the literature. Am J Gastroenterol. 2001;96:585-587. 226 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“both drugs have a comparable efficacy and safety profile.(239)”
What the sources say
- Supportedcites [239] 239. Guanabens N, Monegal A, Cerda D, Muxi A, Gifre L, Peris P, et al. Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with pri- mary biliary cirrhosis. Hepatology. 2013;58:2070-2078. 240 source
The Discussion reports that both drugs increased bone mass and were well tolerated in postmenopausal women with primary biliary cirrhosis and osteoporosis or severe osteopenia. The Results report similar overall adverse-event rates, and the study found no significant difference between groups in lumbar-spine bone-density gains. The comparison is supported for the population studied. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Some 20% to 30% of patients with PBC who undergo transplantation develop recurrent disease over 10 years, and up to 50% do so by 20 years of follow-up.”
What the sources say
- Not checked — no full text of the sourcecites [256] 256. Duclos-Vallee JC, Sebagh M. Recurrence of autoimmune dis- ease, primary sclerosing cholangitis, primary biliary cirrhosis, and autoimmune hepatitis after liver transplantation. Liver Transpl. 2009;15(Suppl 2):S25-S34. 257 source
- Partly supportedcites [257] 257. Bosch A, Dumortier J, Maucort-Boulch D, Scoazec JY, Wendum D, Conti F, et al. Preventive administration of UDCA after liver transplantation for primary biliary cirrhosis is associated with a lower risk of disease recurrence. J Hepatol. 2015;63:1449-1458. 258 sourceExperimental — accuracy not yet measured
The Recurrence Rate section reports recurrent PBC in 17% of patients using strict histologic criteria; Table 4 gives an estimate of 26% using expanded criteria. Neither is a 10-year estimate: the Patient Groups section reports mean follow-up of 4.7 years and a maximum of 13.8 years. The paper does not support the claim of up to 50% recurrence by 20 years. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Several randomized trials, combined analyses, and long-term observational studies have shown that UDCA not only improves biochemical indices but also delays histologic progression and improves survival without transplantation.(53,(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)”
What the sources say
- Not checked — no full text of the sourcecites [53] 53. Corpechot C, Carrat F, Bonnand AM, Poupon RE, Poupon R. The effect of ursodeoxycholic acid therapy on liver fibro- sis progression in primary biliary cirrhosis. Hepatology. 2000;32:1196-1199. source
- Not matchedcites [56] 56. Angulo P, Batts KP, Therneau TM, Jorgensen RA, Dickson ER, Lindor KD. Long-term ursodeoxycholic acid delays histo- logical progression in primary biliary cirrhosis. Hepatology. 1999;29:644-647.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [57] 57. Combes B, Carithers RL Jr, Maddrey WC, Lin D, McDonald MF, Wheeler DE, et al. A randomized, double-blind, place- bo-controlled trial of ursodeoxycholic acid in primary biliary cirrhosis. Hepatology. 1995;22:759-66. source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The bilirubin level is the best predictor of survival and is the most important component in all mathematical models of prognosis in PBC.(71,76)”
What the sources say
- Not checked — no full text of the sourcecites [71] 71. Dickson ER, Grambsch PM, Fleming TR, Fisher LD, Langworthy A. Prognosis in primary biliary cirrhosis: model for decision making. Hepatology. 1989;10:1-7. source
- Not checked — no full text of the sourcecites [76] 76. Grambsch PM, Dickson ER, Kaplan M, LeSage G, Fleming TR, Langworthy AL. Extramural cross-validation of the Mayo primary biliary cirrhosis survival model establishes its generalizability. Hepatology. 1989;10:846-850. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The UK-PBC score involved a cohort of 3,165 patients and found that serum ALP, amino transferases, and bilirubin after 12 months of therapy-as well as albumin and platelets at baseline-predicted the risk of a liver transplant or liver-related death occurring within 5, 10, or 15 years.(75)”
What the sources say
- Not matchedcites [75] 75. Carbone M, Sharp SJ, Flack S, Paximadas D, Spiess K, Adgey C, et al. The UK-PBC risk scores: Derivation and validation of a scoring system for long-term prediction of end-stage liver disease in primary biliary cholangitis. Hepatology. 2016;63:930-950.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelationaln = 3,165- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Compared with AMA-positive PBC patients, AMAnegative PBC patients have more nonhepatic autoimmune conditions (114)(115) and worse health-related quality of life in social and emotional domains.(116)”
What the sources say
- Not checked — no full text of the sourcecites [114] 114. Sakauchi F, Mori M, Zeniya M, Toda G. Antimitochondrial antibody negative primary biliary cirrhosis in Japan: utiliza- tion of clinical data when patients applied to receive public financial aid. J Epidemiol. 2006;16:30-34. 115 source
- Not checked — no full text of the sourcecites [115] 115. Juliusson G, Imam M, Bjornsson ES, A. TJ, Lindor KD. Long- term outcomes in antimitochondrial antibody negatve primary biliary cirrhosis. Scand J Gastroenterol. 2016;51:745-752. 116 source
- Not checked — no full text of the sourcecites [116] 116. Raszeja-Wyszomirska J, Wunsch E, Krawczyk M, Rigopoulou EI, Kostrzewa K, Norman GL, et al. Assessment of health related quality of life in polish patients with primary biliary cirrhosis. Clin Res Hepatol Gastroenterol. 2016;40:471-479. 117 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“These criteria have been met in 1% to 14.2% of PBC patients, with higher rates found in Hispanic PBC patients.(128)(129)(130)(131)(132)(133)”
What the sources say
- Not checked — no full text of the sourcecites [128] 128. Lohse AW, zum Buschenfelde KH, Franz B, Kanzler S, Gerken G, Dienes HP. Characterization of the overlap syndrome of primary biliary cirrhosis (PBC) and autoimmune hepatitis: evidence for it being a hepatitic form of PBC in genetically susceptible individuals. Hepatology. 1999;29:1078-1084. 129 source
- Not checked — no full text of the sourcecites [129] 129. Joshi S, Cauch-Dudek K, Wanless IR, Lindor KD, Jorgensen R, Batts K, et al. Primary biliary cirrhosis with additional fea- tures of autoimmune hepatitis: response to therapy with ur- sodeoxycholic acid. Hepatology. 2002;35:409-413. 130 source
- Not checked — no full text of the sourcecites [130] 130. Heurgue A, Vitry F, Diebold MD, Yaziji N, Bernard-Chabert B, Pennaforte JL, et al. Overlap syndrome of primary biliary cirrhosis and autoimmune hepatitis: a retrospective study of 115 cases of autoimmune liver disease. Gastroenterol Clin Biol. 2007;31:17-25. 131 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The proposed mechanisms of action of UDCA are multiple and include choleretic, cytoprotective, anti-inflammatory, and immunomodulatory properties.(141)”
What the sources say
- Not checked — no full text of the sourcecites [141] 141. Paumgartner G, Beuers U. Ursodeoxycholic acid in cholestatic liver disease: mechanisms of action and therapeutic use revis- ited. Hepatology. 2002;36:525-531. 142 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, the International Autoimmune Hepatitis Group score was designed for the diagnosis of AIH with the exclusion of other liver diseases, including PBC, and therefore positive points are given for the absence of factors unrelated to a diagnosis of PBCe.g., viral hepatitis and alcohol abuse-and negative scores are given for AMA and/or biochemical/histologic features of biliary disease.”
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These patients may no longer have AMA seropositivity, and liver histology becomes more typical of AIH that responds to immunosuppressive therapy.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“UDCA is widely used and has demonstrated the ability to produce a reduction in need for liver transplantation for PBC.(144)”
What the sources say
- Not checked — no full text of the sourcecites [144] 144. Lee J, Belanger A, Doucette JT, Stanca C, Friedman S, Bach N. Transplantation trends in primary biliary cirrhosis. Clin Gastroenterol Hepatol. 2007;5:1313-1315. 145 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“However, treatment response to UDCA appears similar in AMA-negative and AMA-positive PBC patients, and whether there are differences in clinical outcomes has not been resolved.(113,115)”
What the sources say
- Not checked — no full text of the sourcecites [113] 113. Invernizzi P, Crosignani A, Battezzati PM, Covini G, De Valle G, Larghi A, et al. Comparison of the clinical fea- tures and clinical course of antimitochondrial antibody-pos- itive and -negative primary biliary cirrhosis. Hepatology. 1997;25:1090-1095. 114 source
- Not checked — no full text of the sourcecites [115] 115. Juliusson G, Imam M, Bjornsson ES, A. TJ, Lindor KD. Long- term outcomes in antimitochondrial antibody negatve primary biliary cirrhosis. Scand J Gastroenterol. 2016;51:745-752. 116 source
hedged- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The wide variability among studies may be due to a variety of genetic and environmental factors as well as the nonuniform collection of biochemical, serological, immunological, and histological data.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“However, an estimated 50% of patients in either group had received treatment with UDCA, and some in both groups had received a variety of other therapies.”
What the sources say
- Not checked — no full text of the sourcecites [134] 134. Silveira MG, Talwalkar JA, Angulo P, Lindor KD. Overlap of autoimmune hepatitis and primary biliary cirrhosis: long-term outcomes. Am J Gastroenterol. 2007;102:1244-1250. 135 source
hedged- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Some meta-analyses have questioned these results.(142) Often, these meta-analyses include studies of short duration and those that have used what is now known to be an inadequate dose of UDCA.(143)”
What the sources say
- Not checked — no full text of the sourcecites [142] 142. Goulis J, Leandro G, Burroughs AK. Randomised controlled trials of ursodeoxycholic-acid therapy for primary biliary cir- rhosis: a meta-analysis. Lancet. 1999;354:1053-1060. 143 source
- Not checked — no full text of the sourcecites [143] 143. Gong Y, Huang Z, Christensen E, Gluud C. Ursodeoxycholic acid for patients with primary biliary cirrhosis: an updated systematic review and meta-analysis of randomized clinical trials using Bayesian approach as sensitivity analyses. Am J Gastroenterol. 2007;102:1799-1807. 144 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Early studies reported that pruritus (itching) occurs in 20% to 70% of patients with PBC.It is now less common because of the growing number of patients with PBC who are diagnosed in the early, asymptomatic phase.(100)(101)(102)”
What the sources say
- Not checked — no full text of the sourcecites [100] 100. Prince MI, Chetwynd A, Craig WL, Metcalf JV, James OF. Asymptomatic primary biliary cirrhosis: clinical features, prognosis, and symptom progression in a large population based cohort. Gut. 2004;53:865-870. 101 source
- Not checked — no full text of the sourcecites [101] 101. Talwalkar JA, Souto E, Jorgensen RA, Lindor KD. Natural history of pruritus in primary biliary cirrhosis. Clin Gastroenterol Hepatol. 2003;1:297-302. 102 source
- Not checked — no full text of the sourcecites [102] 102. Pares A, Rodes J. Natural history of primary biliary cirrhosis. Clin Liver Dis. 2003;7:779-794. 103 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Right upper quadrant pain is found in approximately 17% of patients with PBC.It is typically nonspecific in character, not progressive in nature, not well correlated with disease stage or hepatomegaly, and often disappears spontaneously.Its etiology is unknown.(108)”
What the sources say
- Not checked — no full text of the sourcecites [108] 108. Laurin JM, DeSotel CK, Jorgensen RA, Dickson ER, Lindor KD. The natural history of abdominal pain asso- ciated with primary biliary cirrhosis. Am J Gastroenterol. 1994;89:1840-1843. 109
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“This score was subsequently revised (122) and, when applied to PBC cohorts, revealed that less than 1% of PBC patients met definite AIH diagnostic criteria, while 8% to 19% met probable AIH criteria.(123)(124)”
What the sources say
- Not checked — no full text of the sourcecites [122] 122. Alvarez F, Berg PA, Bianchi FB, Bianchi L, Burroughs AK, Cancado EL, et al. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol. 1999;31:929-938. 123 source
- Not checked — no full text of the sourcecites [123] 123. Talwalkar JA, Keach JC, Angulo P, Lindor KD. Overlap of auto- immue hepatitis and primary biliary cirrhosis: an evaluation of a modified scoring system. Am J Gastroenterol. 2002;97:1191-1197. 124 source
- Not checked — no full text of the sourcecites [124] 124. Suzuki Y, Arase Y, Ikeda K, Saitoh S, Tsubota A, Suzuki F, et al. Clinical and pathological characteristics of the auto- immune hepatitis and primary biliary cirrhosis overlap syn- drome. J Gastroenterol Hepatol. 2004;19:699-706. 125 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“UDCA with or without immunosuppressive therapy has been used, but no clear consensus on optimal therapy for these patients exists.(129)(130)(134)(135)”
What the sources say
- Not checked — no full text of the sourcecites [129] 129. Joshi S, Cauch-Dudek K, Wanless IR, Lindor KD, Jorgensen R, Batts K, et al. Primary biliary cirrhosis with additional fea- tures of autoimmune hepatitis: response to therapy with ur- sodeoxycholic acid. Hepatology. 2002;35:409-413. 130 source
- Not checked — no full text of the sourcecites [130] 130. Heurgue A, Vitry F, Diebold MD, Yaziji N, Bernard-Chabert B, Pennaforte JL, et al. Overlap syndrome of primary biliary cirrhosis and autoimmune hepatitis: a retrospective study of 115 cases of autoimmune liver disease. Gastroenterol Clin Biol. 2007;31:17-25. 131 source
- Not checked — no full text of the sourcecites [134] 134. Silveira MG, Talwalkar JA, Angulo P, Lindor KD. Overlap of autoimmune hepatitis and primary biliary cirrhosis: long-term outcomes. Am J Gastroenterol. 2007;102:1244-1250. 135 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Budesonide may be helpful, although this is controversial.(180)”
What the sources say
- Not matchedcites [180] 180. Angulo P, Jorgensen RA, Keach JC, Dickson ER, Smith C, Lindor KD. Oral budesonide in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ur- sodeoxycholic acid. Hepatology. 2000;31:318-323. 181
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
- Not matched
In the paper
“A 5-pound weight gain over the first year of therapy has been reported and is not progressive.(155)”
What the sources say
- Not checked — no full text of the sourcecites [155] 155. Siegel JL, Jorgensen R, Angulo P, Lindor KD. Treatment with ur- sodeoxycholic acid is associated with weight gain in patients with primary biliary cirrhosis. J Clin Gastroenterol. 2003;37:183-185. 156 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Altered serotonin neurotransmission may mediate fatigue in chronic liver disease (183) ; however, ondansetron, an antagonist to serotonin receptor, did not relieve fatigue in a clinical trial.(184)”
What the sources say
- Not matchedcites [183] 183. Jones EA. Relief from profound fatigue associated with chronic liver disease by long-term ondansetron therapy. Lancet. 1999;354:397. 184
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [184] 184. Theal JJ, Toosi MN, Girlan L, Heslegrave RJ, Huet PM, Burak KW, et al. A randomized, controlled crossover trial of ondansetron in patients with primary biliary cirrhosis and fa- tigue. Hepatology. 2005;41:1305-1312. 185 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Modafinil, a stimulant used for narcolepsy, was originally reported to lessen fatigue in PBC in open-label studies.(186,187) However, a subsequent placebo-controlled trial failed to show benefit.(188)”
What the sources say
- Not checked — no full text of the sourcecites [186] 186. Kaplan MM, Bonis PA. Modafinil for the treatment of fatigue in primary biliary cirrhosis. Ann Intern Med. 2005;143:546-547. 187 source
- Not checked — no full text of the sourcecites [187] 187. Jones DE, Newton JL. An open study of modafinil for the treatment of daytime somnolence and fatigue in primary bili- ary cirrhosis. Aliment Pharmacol Ther. 2007;25:471-476. 188 source
- Not checked — no full text of the sourcecites [188] 188. Silveira MG, Gossard AA, Stahler AC, Jorgensen RA, Petz JL, Ali AH, et al. A randomized, placebo-controlled clini- cal trial of efficacy and safety: modafinil in the treatment of fatigue in patients with primary biliary cirrhosis. Am J Ther. 2017;24:e167-e76. 189 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Finally, fibrates can cause elevation of transaminases, which is also typically reversible.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Improvement in liver tests are typically observed within a few weeks, and 90% of the improvement usually occurs within 6 to 9 months.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The use of UDCA has been associated with a reduction of serum low-density lipoprotein cholesterol levels, a reduced risk of developing varices, and slower histologic progression.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This is typically reversible and not associated with a decline in glomerular filtration rate, but it is attributed to an increase in creatinine production.(167)”
What the sources say
- Not checked — no full text of the sourcecites [167] 167. Davidson MH, Armani A, McKenney JM, Jacobson TA. Safety considerations with fibrate therapy. Am J Cardiol. 2007;99:3C-18C. 168 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Furthermore, improvement in pruritus and beneficial effects on markers of fibrosis were also observed.”
What the sources say
- Not checked — no full text of the sourcecites [94] 94. Corpechot C, Chazouillères O, Rousseau A, Guyader D, Habersetzer F, Mathurin P, et al. A 2-year multicenter, double-blind, randomized, placebo-controlled study of be- zafibrate for the treatment of primary biliary cholangitis in patients with inadequate biochemical response to ursodeoxy- cholic acid therapy (Bezurso). J Hepatol. 2017;66:S89. source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“OCA is a farnesoid X receptor (FXR) agonist that is 100 times more potent than the endogenous ligand, chenodeoxycholic acid.(156)”
What the sources say
- Not checked — no full text of the sourcecites [156] 156. Pellicciari R, Fiorucci S, Camaioni E, Clerici C, Costantino G, Maloney PR, et al. 6α-ethyl-chenodeoxycholic acid (6- ECDCA), a potent and selective FXR agonist endowed with anticholestatic activity. J Med Chem. 2002;45:3569-3572. 157 source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Notably, use of fibrates can be associated with myalgias and heartburn, and an elevation in serum creatinine is frequently observed.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Older patients and those with lower fibrosis scores were more likely to respond.”
What the sources say
- Not checked — no full text of the sourcecites [166] 166. Reig A, Sese P, Pares A. Effects of bezafibrate on outcome and pruritus in primary biliary cholangitis with subopti- mal ursodeoxycholic acid response. Am J Gastroenterol. 2018;113:49-55. 167 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These comorbidities both promote disease progression and may put the individual at risk of not being accepted for a liver transplant should the latter become necessary.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Estrogens promote cholestasis, so oral contraceptive pills and estrogen supplements may induce or worsen pruritus.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“Intractable fatigue is not a valid indication for liver transplantation because fatigue usually persists post transplant.(189)”
What the sources say
- Not checked — no full text of the sourcecites [189] 189. Carbone M, Bufton S, Monaco A, Griffiths L, Jones DE, Neuberger JM. The effect of liver transplantation on fatigue in patients with primary biliary cirrhosis: a prospective study. J Hepatol. 2013;59:490-494. 190 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At this time, there is no recommended therapy for the fatigue resulting from PBC.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A short second stage of labor is optimal because the Valsalva maneuver may precipitate variceal hemorrhage.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“It is not known which substance in the gut they may be binding to that leads to improved cholestatic itching, and clinical trials proving their efficacy are limited, but they have a long track record of clinical use.(190,191)”
What the sources say
- Not checked — no full text of the sourcecites [190] 190. Datta DV, Sherlock S. Cholestyramine for long term re- lief of the pruritus complicating intrahepatic cholestasis. Gastroenterology. 1966;50:323-332. 191 source
- Not checked — no full text of the sourcecites [191] 191. Van Itallie TB, Hashim SA, Crampton RS, Tennent DM. The treatment of pruritus and hypercholesteremia of pri- mary biliary cirrhosis with cholestyramine. N Engl J Med. 1961;265:469-474. 192 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are limited data about fertility or infant outcome in PBC patients.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The majority of individuals currently have no symptoms referable to their liver disease when diagnosed with PBC.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This lack of symptoms makes it particularly difficult for an individual to recognize the importance of preventive strategies in PBC.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Colesevalam was not effective in a single placebo-controlled trial of cholestatic pruritus.(192) However, only patients who had already failed other resins were enrolled.”
What the sources say
- Not checked — no full text of the sourcecites [192] 192. Kuiper EM, van Erpecum KJ, Beuers U, Hansen BE, Thio HB, de Man RA, et al. The potent bile acid sequestrant cole- sevelam is not effective in cholestatic pruritus: results of a dou- ble-blind, randomized, placebo-controlled trial. Hepatology. 2010;52:1334-1340. 193 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Sertraline, given at a dose of 75 to 100 mg, helped relieve pruritus in a single, small, placebo-controlled trial and in a retrospective case series.The effect was independent from an improvement in depression.(209)”
What the sources say
- Not checked — no full text of the sourcecites [209] 209. Mayo MJ, Handem I, Saldana S, Jacobe H, Getachew Y, Rush AJ. Sertraline as a first-line treatment for cholestatic pruritus. Hepatology. 2007;45:666-674. 210 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Phenobarbital can improve cholestatic pruritus but is a strong sedative that worsens or initiates fatigue, increases vitamin D deficiency, and has been associated with troublesome gingival hyperplasia.(213)”
What the sources say
- Not checked — no full text of the sourcecites [213] 213. Bloomer JR, Boyer JL. Phenobartial effectis in cholestatic liver disease. Ann Intern Med. 1975;82:310-317. 214 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients with PBC may develop portal hypertension as a result of biliary cirrhosis or, in the precirrhotic stage of the disease, in association with nodular regenerative hyperplasia.(232,233)”
What the sources say
- Not matchedcites [232] 232. Kew MC, Varma RR, Santos HAD, Scheuer PJ. Portal hyper- tension in primary biliary cirrhosis. Gut. 1971;12:830-834. 233
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [233] 233. Abraham SC, Kamath PS, Eghtesad B, Demetris AJ, Krasinskas AM. Liver transplantation in precirrhotic bili- ary tract disease: Portal hypertension is frequently associated with nodular regenerative hyperplasia and obliterative portal venopathy. Am J Surg Pathol. 2006;30:1454-1461. 234 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Similarly, during pregnancy, itching may become severe even early on in the pregnancy, and it may fail to resolve completely after delivery in patients with PBC.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Ondansetron, a serotonin antagonist, was initially reported to decrease cholestatic itch but was later found to be no better than placebo in more rigorous trials.(210)(211)(212)”
What the sources say
- Not checked — no full text of the sourcecites [210] 210. Raderer M, Muller C, Scheithauer W. Ondansetron for pruri- tus due to cholestasis. N Engl J Med. 1994;330:1540. 211 source
- Not checked — no full text of the sourcecites [211] 211. Schworer H, Ramadori G. Improvement of cholestatic pruri- tus by ondansetron. Lancet. 1993;341:1277. 212 source
- Not checked — no full text of the sourcecites [212] 212. Jones EA, Molenaar HA, Oosting J. Ondansetron and pruritus in chronic liver disease: a controlled study. Hepatogastroenterology. 2007;54:1196-1199. 213
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Patients with dry mouth are at increased risk of dental caries and should receive regular professional dental cleanings and check-ups.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Treatment with beta blockers is safe in pregnancy.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“This has been challenged by a meta-analysis that identified a pooled risk of 1.57 (95% CI, 1.21-2.06)(247)”
What the sources say
- Not checked — no full text of the sourcecites [247] 247. Ungprasert P, Wijarnpreecha K, Ahuja W, Spanuchart I, Thongprayoon C. Coronary artery disease in primary biliary cirrhosis: A systematic review and meta-analysis of observa- tional studies. Hepatol Res. 2015;45:1055-1061. 248 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Long-term immunosuppression with a cyclosporine-based regimen seems to be associated with reduced incidence of recurrent PBC, but this is not proven.(259)”
What the sources say
- Not checked — no full text of the sourcecites [259] 259. Charatcharoenwitthaya P, Pimentel S, Talwalkar JA, Enders FT, Lindor KD, Krom RA, et al. Long-term survival and im- pact of ursodeoxycholic acid treatment for recurrent primary biliary cirrhosis after liver transplantation. Liver Transpl. 2007;13:1236-1245. 260 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Osteopenia may worsen for the first 6 months after transplantation, but bone mineral density returns to baseline after 12 months and improves thereafter.(254)”
What the sources say
- Not checked — no full text of the sourcecites [254] 254. Eastell R, Dickson ER, Hodgson SF, Wiesner RH, Porayko MK, Wahner HW, et al. Rates of vertebral bone loss before and after liver transplantation in women with primary biliary cirrhosis. Hepatology. 1991;14:296-300. 255 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Fatigue improves in a subset of patients with PBC, but moderate to severe fatigue continues to affect nearly half of patients 2 years after liver transplantation.(189)”
What the sources say
- Not checked — no full text of the sourcecites [189] 189. Carbone M, Bufton S, Monaco A, Griffiths L, Jones DE, Neuberger JM. The effect of liver transplantation on fatigue in patients with primary biliary cirrhosis: a prospective study. J Hepatol. 2013;59:490-494. 190 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the same study, the 1-, 3-, 5-, and 10-year graft survival rates were 85%, 80%, 78.1%, and 71.9%, and the 1-, 3-, 5-, and 10-year patient survival rates were 90.2%, 86.7%, 84.4%, and 79%, respectively.(253)”
What the sources say
- Not checked — no full text of the sourcecites [253] 253. Singal AK, Guturu P, Hmoud B, Kuo YF, Salameh H, Wiesner RH. Evolving frequency and outcomes of liver trans- plantation based on etiology of liver disease. Transplantation. 2013;95:755-760. 254 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Hormone replacement therapy has led to some improvement in bone mineral density, but these agents are seldom used because of safety concerns.(243)”
What the sources say
- Not checked — no full text of the sourcecites [243] 243. Boone RH, Cheung AM, Girlan LM, Heathcote EJ. Osteoporosis in primary biliary cirrhosis: a randomized trial of the efficacy and feasibility of estrogen/progestin. Dig Dis Sci. 2006;51:1103-1112. 244 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Accepted treatments for sicca syndrome work equally well in patients with PBC even though they have not been studied specifically in that population.
“Although not studied specifically in patients with PBC, accepted treatments for sicca syndrome appear to work equally well in this population.”
The paper relies on this without support.
OCA was approved by the Food and Drug Administration in May 2016 for use with UDCA in PBC patients with inadequate response to at least 1 year of UDCA or as monotherapy for UDCA-intolerant patients.
“OCA was approved by the Food and Drug Administration in May 2016 to be used in combination with UDCA in patients with PBC who have inadequate response to at least 1 year of treatment with UDCA, or as monotherapy for those patients who are intolerant to UDCA.”
The paper relies on this without support.
Men and those with advanced disease are most likely to develop hepatocellular cancer.
“Men and patients with advanced disease are most apt to develop hepatocellular cancer”
The paper relies on this without support.
Hepatocellular cancer occurs at 3.9 cases per 1,000 person-years in PBC.
“which was found at a rate of 3.9 cases in 1,000 per year of follow-up.”
The paper relies on this without support.
Fat-soluble vitamin deficiency is uncommon in most PBC patients.
“Most PBC patients do not develop fat-soluble vitamin (vitamins A, D, E, and K) deficiency.”
The paper relies on this without support.
Chronic fatigue is not a transplant indication since it does not always reverse after liver transplantation.
“Chronic fatigue is not an indication for transplant because this symptom is not universally reversible after liver transplantation.”
The paper relies on this without support.
Severe, intractable pruritus is an uncommon indication for liver transplantation.
“Severe intractable pruritus is an exceptional indication for liver transplantation.”
The paper relies on this without support.
Liver transplantation indications for PBC resemble those for other chronic liver diseases.
“Indications for liver transplantation for patients with PBC are similar to those with other forms of chronic liver disease.”
The paper relies on this without support.
Platelet counts can guide the need for endoscopic surveillance.
“Platelet counts can be used to determine the need for endoscopic surveillance.”
The paper relies on this without support.
UDCA lowers LDL cholesterol and is the first-line step.
“UDCA will lower low-density lipoprotein cholesterol levels and is the initial step.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Currently, fibrates are only approved by the FDA as lipid-lowering medications in the United States (US) and multiple countries rather than PBC treatment [7].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The AASLD notes that fibrates, including fenofibrate, may improve pruritus in PBC, based on observational studies and clinical experience, but most high-quality randomized controlled trial data specifically address bezafibrate rather than fenofibrate [7].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The AASLD notes that fenofibrate can cause transient elevations in transaminases, but not associated with any toxicity and normalize with therapy discontinuation [7].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The fibrates modulate hepatic stellate cell activation; as it regulates bile acid synthesis and detoxification, and phospholipid secretion [7,38].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“These effects collectively reduce cholesterol and hepatic inflammation, and it reflects by reductions in serum ALP and GGT levels [7,15,39].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Clinically, primary biliary cholangitis is characterised by persistent elevation of cholestatic liver enzymes, including alkaline phosphatase and gammaglutamyl transpeptidase (GGT), and detection of antimitochondrial antibodies or primary biliary cholangitis-specific anti-nuclear antibodies (anti-sp100 or anti-gp210).[3][4][5]”
From Primary biliary cholangitis. (2024) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Non-invasive liver stiffness measurement (LSM) has proven useful as an alternative to invasive liver biopsy for the evaluation of liver fibrosis, and LSM using transient elastography is recommended at the time of diagnosis.3,4,55”
From Primary biliary cholangitis. (2024) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Histological assessment requires an adequate biopsy specimen containing at least 10-15 portal tracts obtained using a 16 g needle because the intensity of chronic non-suppurative destructive cholangitis and focal loss of bile ducts vary along the length of individual interlobular bile ducts in primary biliary cholangitis.4”
From Primary biliary cholangitis. (2024) · cites this paper as [4]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“According to the American Association for the Study of Liver Diseases (AASLD), ursodeoxycholic acid (UDCA) is the first-line treatment for PBC [7].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
The cited source says what the claim attributes to it.
In the citing paper
“An increase in bilirubin can occur. This has been attributed to competitive inhibition of the transporter organic-anion-transporting polypeptide, which transports both bile acids and bilirubin, among other endogenous substances [7].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
The cited source says what the claim attributes to it.
In the citing paper
“Fenofibrate may cause reversible elevations in serum creatinine, likely due to increased creatinine production rather than a true decline in the glomerular filtration rate [7,42].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
The cited source says what the claim attributes to it.
In the citing paper
“The AASLD considers fibrates an off-label option for PBC patients with incomplete UDCA response but advises against their use in decompensated liver disease (Child-Pugh B and C) due to lack of safety data and potential risk of hepatotoxicity [7].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [7]
The cited source says what the claim attributes to it.
In the citing paper
“A diagnosis of primary biliary cholangitis is made if patients meet at least two of the following criteria: have biochemical evidence of chronic cholestasis, positive anti-mitochondrial antibodies in sera, and histological features compatible with primary biliary cholangitis.[3][4][5]”
From Primary biliary cholangitis. (2024) · cites this paper as [4]
The cited source says what the claim attributes to it.
In the citing paper
“Ursodeoxycholic acid is standard-of-care treatment for primary biliary cholangitis.”
From Primary biliary cholangitis. (2024) · cites this paper as [4]
The cited source says what the claim attributes to it.
In the citing paper
“Clinical practice guidelines from the European Association for the Study of the Liver, the American Association for the Study of Liver Diseases (AASLD), and the Asian-Pacific Association for the Study of the Liver recommend ursodeoxycholic acid treatment (13-15 mg/kg per day) for all patients with primary biliary cholangitis and elevated cholestatic enzymes.[3][4][5]”
From Primary biliary cholangitis. (2024) · cites this paper as [4]
The cited source says what the claim attributes to it.
In the citing paper
“In addition, the liver stiffness measurement (LSM) in stratifying the risk for progression has been confirmed.3,4,55”
From Primary biliary cholangitis. (2024) · cites this paper as [4]
In the citing paper
“In PBC, UDCA is used as first-line treatment,2 66 67 but 30%–50% of patients respond insufficiently (based on biochemical criteria)”
From Novel therapeutic targets for cholestatic and fatty liver disease (2022) · cites this paper as [67]
In the citing paper
“Current guideline-recommended medical treatment options for pruritus of cholestasis include the anion exchange resin cholestyramine, the pregnane X receptor (PXR) agonist rifampicin, the opioid antagonist naltrexone, and the selective serotonin reuptake inhibitor sertraline.4,7 Efficacy or tolerability of these drugs, or both, are limited.8,9”
From Fibrates for Itch (FITCH) in Fibrosing Cholangiopathies: A Double-Blind, Randomized, Placebo-Controlled Trial (2021) · cites this paper as [7]
In the citing paper
“Patients with PBC have a significantly greater risk of osteopenia and osteoporosis than age-matched and sex-matched controls [40].”
From Bone diseases in patients with chronic liver disease (2019) · cites this paper as [40]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ loNg-terM FolloW-Up
“For patients with known cirrhosis with a Mayo risk score greater than 4.1 or transient elastography values of at least 7 kPa, upper endoscopy to assess for varices should be done every 2 to 3 years.”
§ HepatoCellUlar CarCiNoMa
“Upper endoscopy every 1-3 years if cirrhotic, Mayo risk score >4.1, or transient elastography shows a score ≥17 kPa*”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ liVer traNSplaNtatioN
“Alendronate is a more effective treatment than etidronate, (255) but there are no studies to confirm the longterm efficacy of any treatment.”
§ References
“255. Baldo-Enzi G, Baiocchi MR, Grotto M, Floreani AR, Zagolin M, Chiaramonte M, et al. Lipoprotein pattern and plasma lipo- protein lipase activities in patients with primary biliary cirrhosis.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ otHer aUtoiMMUNe CoNditioNS
“There are three major autoimmune diseases that have been shown in a cohort study to occur significantly more often in PBC than the age-matched and sex-matched population:”
§ otHer aUtoiMMUNe CoNditioNS
“Sjögren syndrome; calcinosis, Raynaud, esophageal dysfunction, sclerodactyly, and telangectasias (CREST); scleroderma (systemic sclerosis); and Raynaud disease.”
Citations
Cites
Alvarez, F., Berg, P. A., Bianchi, F. B., Bianchi, L., Burroughs, A. K., Cancado, E. L., Chapman, R. W., Cooksley, W. G. E., Czaja, A. J., Desmet, V. J., et al. (1999) · Journal of Hepatology · doi:10.1016/s0168-8278(99)80297-9 · Cited by 2,903
Garcia‐Tsao, G., Abraldes, J. G., Berzigotti, A., & Bosch, J. (2017) · Hepatology · doi:10.1002/hep.28906 · Cited by 2,154
Kaplan, M. M. (1987) · New England Journal of Medicine · doi:10.1056/nejm198702263160907 · Cited by 2,016
Targeting bile‐acid signalling for metabolic diseases
Thomas, C., Pellicciari, R., Pruzanski, M., Auwerx, J., & Schoonjans, K. (2008) · Nature Reviews Drug Discovery · doi:10.1038/nrd2619 · Cited by 1,422 · cited 2×
“(157,158) In animal models, FXR activation has demonstrated antifibrotic and anti-inflammatory properties as well.(157) A phase 2 randomized controlled trial evaluated 3 doses of OCA (10 mg, 25 mg, and 50 mg) against placebo for 3 months in a study including 165 patients.”
BackgroundKaplan, M. M., & Gershwin, M. E. (2005) · New England Journal of Medicine · doi:10.1056/nejmra043898 · Cited by 1,144
A Placebo-Controlled Trial of Obeticholic Acid in Primary Biliary Cholangitis
Nevens, F., Andreone, P., Mazzella, G., Strasser, S. I., Bowlus, C., Invernizzi, P., Drenth, J. P. H., Pockros, P. J., Regula, J., Beuers, U., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1509840 · Cited by 1,131 · cited 1×
“After 1 year, this primary endpoint was met by 46% of patients in the titration group, 47% in the 10 mg/day group, and 10% of patients in the placebo group.(161) Improvements in other liver chemistries and inflammatory markers were also noted in OCA-treated patients.”
BackgroundSelf-citationMartin, P., DiMartini, A., Feng, S., Brown, R., & Fallon, M. (2014) · Hepatology · doi:10.1002/hep.26972 · Cited by 1,045
Prognosis in primary biliary cirrhosis: Model for decision making
Dickson, R. E., Grambsch, P. M., Fleming, T. R., Fisher, L. D., & Langworthy, A. (1989) · Hepatology · doi:10.1002/hep.1840100102 · Cited by 816 · cited 3×
“(70) Once the Mayo model was introduced by Dickson, prognosis could be estimated without the need for biopsy.(71) Following the introduction of UDCA therapy, a series of models—which are summarized in recent reviews(72-73) and most of which were based on alkaline phosphatase (ALP) responses to treatment— ensued.”
BackgroundMethodInfluentialJohnson, P. J., Qin, S., Park, J.-W., Poon, R. T. P., Raoul, J.-L., Philip, P. A., Hsu, C.-H., Hu, T.-H., Heo, J., Xu, J., et al. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.48.4410 · Cited by 772
Parés, A., Caballería, L., & Rodés, J. (2006) · Gastroenterology · doi:10.1053/j.gastro.2005.12.029 · Cited by 756
Research works printed but not linked: 2
- 2016, Screening of antimitochondrial antibody subtype M2 in residents at least 18 years of age in an urban district of Shanghai, China. Eur Rev Med Pharmacol Sci, 20, 2052
- 2005, Practice Guidelines Committee AAftSoLD, Management of hepatocellular carcinoma. Hepatology, 42, 1208
Cited by
Sorted by citations
Evidence-based clinical practice guidelines for Liver Cirrhosis 2020
Yoshiji, H., Nagoshi, S., Akahane, T., Asaoka, Y., Ueno, Y., Ogawa, K., Kawaguchi, T., Kurosaki, M., Sakaida, I., Shimizu, M., et al. (2021) · Journal of Gastroenterology · doi:10.1007/s00535-021-01788-x · Cited by 462
“European and American guidelines recommend a dose of 13 to 15 mg/kg of body weight per day [52, 53].”
BackgroundDiagnosis and Management of Cirrhosis and Its Complications
Tapper, E. B., & Parikh, N. D. (2023) · JAMA · doi:10.1001/jama.2023.5997 · Cited by 422
Primary biliary cholangitis: pathogenesis and therapeutic opportunities
Gulamhusein, A. F., & Hirschfield, G. M. (2020) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-019-0226-7 · Cited by 308
Harms, M. H., van Buuren, H. R., Corpechot, C., Thorburn, D., Janssen, H. L. A., Lindor, K. D., Hirschfield, G. M., Parés, A., Floreani, A., Mayo, M. J., et al. (2019) · Journal of Hepatology · doi:10.1016/j.jhep.2019.04.001 · Cited by 289
Self-citationA Phase 3 Trial of Seladelpar in Primary Biliary Cholangitis
Hirschfield, G. M., Bowlus, C. L., Mayo, M. J., Kremer, A. E., Vierling, J. M., Kowdley, K. V., Levy, C., Villamil, A., Ladrón de Guevara Cetina, A. L., Janczewska, E., et al. (2024) · New England Journal of Medicine · doi:10.1056/nejmoa2312100 · Cited by 286
Self-citation
Metadata
- Authors
- Lindor, K. D., Bowlus, C. L., Boyer, J., Levy, C., & Mayo, M.
- Affiliations
- Mayo Clinic (US)
- University of California, Davis (US)
- Yale University (US)
- University of Miami (US)
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Lindor, Keith D.
- Venue
- Hepatology
- Published
- 2018-11-06
- Volume
- 69
- Issue
- 1
- Pages
- 394-419
- ISSN
- 0270-9139 (ISSN-L)
- 1527-3350
- OpenAlex
- W2886703787
- Cited by
- 913
- References
- 263
- Citations by year
- 2026: 126 · 2025: 147 · 2024: 143 · 2023: 131 · 2022: 114 · 2021: 113 · 2020: 81 · 2019: 55 · 2018: 2
- FWCI
- 39.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- GlaxoSmithKline
- American Association for the Study of Liver Diseases
- Gilead Sciences
- Allergan
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Keywords
- primary biliary cirrhosis, obeticholic acid, antimitochondrial antibodies, autoimmune etiology, diagnosis, imaging, clinical features, treatment, screening, cholestasis, liver fibrosis, biliary strictures, cholangitis
- MeSH terms
- Humans, Liver Cirrhosis, Biliary
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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