UDCA, PBC and biochemistry: what does normal mean?

Kd, Lindor

doi:10.1136/gut.46.1.8

Cited by 3 publications

(2 citation statements)

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“…In addition to higher prevalence and better detection, there is a possibility that treatment regimens may fail in a number of patients who end up in the inpatient setting with advanced liver disease with PBC. In fact, almost 40% of patients with PBC treated with UDCA fail to achieve optimal response and are at risk for progressive liver disease . Our study reveals that the severity of illness as reflected by higher CCI and risk of death for inpatients with PBC increased over the study period.…”

Section: Discussionmentioning

confidence: 72%

“…PBC is usually diagnosed by liver enzyme abnormalities and the presence of antimitochondrial antibodies in the absence of extrahepatic biliary obstruction or other liver disease . Since the 1980s, ursodeoxycholic acid (UDCA) has become the mainstay for treatment of PBC . UDCA is not a definitive cure, but treatment can slow disease progression and delay the need for liver transplantation .…”

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confidence: 99%

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Burden of Primary Biliary Cholangitis Among Inpatient Population in the United States

et al. 2019

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Primary biliary cholangitis (PBC) is an autoimmune liver disease that can lead to cirrhosis and liver failure. Our aim was to assess the recent trends in the mortality rates and health care utilization of patients with PBC seen in the inpatient setting in the United States. We used the National (Nationwide) Inpatient Sample data (2005‐2014). The study population included adults with PBC, using International Classification of Diseases, Ninth Revision codes. Trends in PBC‐related discharges, total charges, length of stay (LoS), and in‐hospital mortality were evaluated. Hierarchical generalized linear models were performed for determining predictors of mortality and total hospital charges. Between the study years of 2005 and 2014, a total of 22,665 hospitalized cases with PBC were identified (mean age 63 years; 84% female, 76% white). The number of PBC‐related discharges increased from 3.24 per 100,000 in 2005 to 3.68 per 100,000 in 2014, with an average annual increase of 1.4% (95% confidence interval [CI]: 0.4%‐2.4%). Fifty‐seven percent had Medicare as their primary payer, 37% had cirrhosis, and 1.3% had hepatocellular carcinoma. Between 2005 and 2014, the average total charges for PBC increased from $53,901 to $57,613 (annual percent change [APC], 1.7%; 95% CI: −0.2%‐3.5%), LoS decreased from 6.9 days to 5.4 days (APC, −2.2%; 95% CI: −3.2% to −1.1%), and mortality rate decreased from 3.8% to 2.8% (APC, −5.4%; 95% CI: −8.4% to −2.4%). Multivariable analysis revealed that ascites were independently associated with increased risk of in‐hospital mortality (odds ratio: 1.77; 95% CI: 1.50‐2.08), increased charge (percent change: 22.5%; 95% CI: 18.6%‐26.7%), and increased LoS (percent change: 29.7%; 95% CI: 25.7%‐33.9%). Conclusion: The number of PBC cases has increased in recent years. Mortality and LoS have decreased, and the total charges have remained the same.

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Section: Discussionmentioning

confidence: 72%

mentioning

confidence: 99%