Ursodeoxycholic acid (UDCA) is known to slow the progression of primary biliary cirrhosis (PBC). However, this therapy is ineffective in some patients who progress towards cirrhosis and end-stage disease.
A study by a team from two hospitals in Paris, France, has now examined the incidence of cirrhosis in UDCA-treated patients with PBC.
The research group also attempted to determine the predictive factors of cirrhosis development under this treatment.
|Serum bilirubin >17 µmol/L; an independent factor for cirrhosis development|
Using a Markov model, the progression towards cirrhosis was measured in 183 UDCA-treated patients with PBC.
In addition, a total of 254 pairs of liver biopsy specimens, collected during 655 patient-years, were also studied.
The incidence of cirrhosis after 5 years of UDCA therapy was 4%, 12%, and 59% among patients followed up from Stages I, II, and III, respectively.
At 10 years, the likelihood of progressing towards cirrhosis had risen to 17%, 27%, and 76%.
The median time for developing cirrhosis from Stages I, II, and III was 25 years, 20 years, and 4 years, respectively.
The research group found independent factors for cirrhosis development to be serum bilirubin greater than 17 µmol/L, serum albumin less than 38 g/L, and moderate to severe lymphocytic piecemeal necrosis.
Christophe Corpechot, first author of the paper, said that the 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."