Primary biliary cirrhosis: Incidence and predictive factors of cirrhosis development in ursodiol-treated patients
Open accessAbstract
Background & aims Ursodeoxycholic acid (UDCA) slows the progression of primary biliary cirrhosis (PBC). However, some UDCA-treated patients escape and progress toward cirrhosis and end-stage disease. This study aimed to assess the incidence of cirrhosis in UDCA-treated patients with PBC and to determine the predictive factors of cirrhosis development under this treatment.Methods A Markov model was used to describe the progression toward cirrhosis in 183 UDCA-treated patients with PBC. A total of 254 pairs of liver biopsy specimens collected during 655 patient-years were studied.Results The incidence of cirrhosis after 5 years of UDCA treatment was 4%, 12%, and 59% among patients followed-up from stages I, II, and III, respectively. At 10 years, the incidence was 17%, 27%, and 76%, respectively. The median time for developing cirrhosis from stages I, II, and III was 25 years, 20 years, and 4 years, respectively. The independent predictive factors of cirrhosis development were serum bilirubin greater than 17 mumol/L, serum albumin less than 38 g/L, and moderate to severe lymphocytic piecemeal necrosis.Conclusions This study provides new data about the time course of PBC under UDCA and constitutes a rationale for the design and evaluation of clinical trials aimed to assess the efficacy of drugs associated with UDCA.
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The presence of a lymphoplasmacytic interface hepatitis is a marker of more rapidly progressive disease.
“A detailed review of liver histology suggests that the presence of a lymphoplasmacytic interface hepatitis is a marker of more rapidly progressive disease14 96”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [96]
The Results and Discussion (page unavailable in our copy) identify the severity of lymphocytic piecemeal necrosis as an independent predictor of histologic progression toward cirrhosis in ursodiol-treated patients with primary biliary cirrhosis. The paper does not establish that the mere presence of specifically lymphoplasmacytic interface hepatitis predicts more rapid progression. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe incidence of cirrhosis after 5 years of UDCA treatment was 4% and 59% among patients followed-up from stages 1 and 3, respectively (17% and 76%, respectively after 10 years). The median time for developing cirrhosis from stages 1 and 3 was 25 years and 4 years, respectively.
“The incidence of cirrhosis after 5 years of UDCA treatment was 4% and 59% among patients followed-up from stages 1 (early disease) and 3 (fibrosis), respectively (17% and 76%, respectively after 10 years). The median time for developing cirrhosis from stages 1 and 3 was 25 years and 4 years, respectively.”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [96]
The independent predictive factors of cirrhosis development were serum bilirubin >17 μmol/L, serum albumin <38 g/L and moderate to severe lymphocytic interface hepatitis.
“The independent predictive factors of cirrhosis development were serum bilirubin >17 µmol/L, serum albumin <38 g/L and moderate to severe lymphocytic interface hepatitis.”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [96]
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References 27 · Cited by 169
- Authors
- Corpechot, C., Carrat, F., Poupon, R., & Poupon, R.
- Affiliations
- Hôpital Saint-Antoine (FR)
- Inserm (FR)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2002-03
- Volume
- 122
- Issue
- 3
- Pages
- 652-658
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2123805246
- Cited by
- 169
- References
- 27
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 8 · 2020: 5 · 2019: 8 · 2018: 6 · 2017: 6 · 2016: 6 · 2015: 9 · 2014: 9 · 2013: 6 · 2012: 8
- FWCI
- 6.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- 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, ursodeoxycholic acid, disease progression, predictive factors, serum bilirubin, serum albumin, Markov model, liver biopsy staging
- MeSH terms
- Bilirubin, Cholagogues and Choleretics, Female, Humans, Liver, Liver Cirrhosis, Biliary, Male, Markov Chains, Middle Aged, Necrosis, Predictive Value of Tests, Prognosis, Risk Factors, Serum Albumin, Ursodeoxycholic Acid, Incidence, Multivariate Analysis, Disease Progression
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