Predictive Model of Ursodeoxycholic Acid Treatment Response in Primary Biliary Cholangitis

Abstract

Background and Aims: Although ursodeoxycholic acid (UDCA) treatment in primary biliary cholangitis is effective in many patients, there are still many people who respond poorly to it. Identifying and intervening these patients early is important. Therefore, exploring the risk factors and proposing a predictor index to predict the UDCA treatment nonresponse earlier among primary biliary cholangitis patients were the aims of this research. Methods: A total of 135 primary biliary cholangitis patients treated with UDCA (13-15 mg/kg/d) were enrolled in this retrospective study. The response to treatment was evaluated based on Paris I criteria. The univariate and logistic multivariate regression analyses were adopted to determine the independent risk factors and propose a predictor index. Receiver operating characteristic curve was used to evaluate the predictive ability of the predictor index. Results: Total bilirubin, albumin, globulin, immunoglobin M, and aspartate aminotransferase-to-platelet ratio index were the five independent risk factors associating with early biochemical nonresponse to UDCA treatment. Based on these factors, we established a predictor index with the predictive value being 0.886 (sensitivity: 82.80%, specificity: 84.40%). Conclusions: We developed a predictor index that had an accurate prediction of the early biochemical nonresponse to UDCA treatment, which is expected to provide valuable information for the high-risk group before treatment begins.

A new and simple score to predict adequate and deep response to ursodeoxycholic acid in patients with primary biliary cholangitis: the ALP-A score

“…The AUROC of the score model in the derivation group and the verification group was 0.763 (95% CI, 0.701–0.817, P < 0.001) and 0.798 (95% CI, 0.681–0.887, P < 0.001), respectively [31]. A different approach was used in a Chinese study, which elaborated a nomogram to predict the probability of inadequate biochemical response to UDCA, including sex, albumin, and bilirubin levels as influencing factors of drug response [32]. Finally, noninvasive liver fibrosis evaluation using vibration-controlled transient elastography in treatment-naive patients has been suggested for early risk stratification in PBC [33,34].…”

The gut microbiome predicts response to UDCA/CDCA treatment in gallstone patients: comparison of responders and non-responders

“…Prospective studies have reported response rates to UDCA/CDCA treatment ranging from 43.2 to 47.2%. However, with the exception of GB stone size, the factors affecting response to treatment remain unidentified 6 , 7 , 11 – 13 . Furthermore, no biomarker has been identified that accurately predicts response to UDCA/CDCA treatment for managing GB stones.…”