Autoantibody status and histological variables influence biochemical response to treatment and long-term outcomes in Japanese patients with primary biliary cirrhosis

Minoru Nakamura, Hisayoshi Kondo, Atsushi Tanaka, Atsumasa Komori, Masahiro Ito, Kazuhide Yamamoto, Hiromasa Ohira, Mikio Zeniya, Etsuko Hashimoto, Masao Honda, Shuichi Kaneko, Yoshiyuki Ueno, Kentaro Kikuchi, Shinji Shimoda, Kenichi Harada, Kuniaki Arai, Yasuhiro Miyake, Masanori Abe, Makiko Taniai, Toshiji SaibaraShotaro Sakisaka, Hajime Takikawa, Morikazu Onji, Hirohito Tsubouchi, Yasuni Nakanuma, Hiromi Ishibashi

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

Aim: The aim of the present study is to evaluate the factors influencing biochemical response to treatment and the value of biochemical response for predicting long-term outcomes in Japanese patients with primary biliary cirrhosis (PBC). Methods: Biochemical response to ursodeoxycholic acid (UDCA) or UDCA plus bezafibrate was defined as good (≤upper limit of normal [ULN]), fair (≤1.5×ULN) or poor (>1.5×ULN) at 2 years after initiation of UDCA treatment. Associations between various factors (including age, sex, autoantibody status and histological variables at baseline), biochemical response to treatment and long-term outcomes were evaluated in 164 Japanese PBC patients. Results: Anti-gp210 positivity and a higher bile duct loss score were significant risk factors for worse alkaline phosphatase (ALP) response (odds ratios [OR], 2.78 and 1.85, respectively). Age, anti-gp210 positivity and anticentromere positivity were significant risk factors for worse alanine aminotransferase (ALT) response (OR, 1.05, 4.0 and 2.77, respectively). Anti-gp210 positivity and a higher hepatitis score were significant risk factors for worse immunoglobulin (Ig)M response (OR, 2.10 and 2.06, respectively). Worse ALP and IgM response were significant risk factors for progression to late-stage disease without jaundice (OR, 2.27 and 2.32, respectively). Worse ALT response was a significant risk factor for progression to late-stage disease with persistent jaundice (OR, 11.11). Conclusion: Biochemical response to treatment at 2 years, which is influenced by autoantibody status and histological variables at baseline, can predict long-term outcomes in Japanese patients with PBC.

Original languageEnglish
Pages (from-to)846-855
Number of pages10
JournalHepatology Research
Volume45
Issue number8
DOIs
Publication statusPublished - Aug 1 2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases

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