The efficacy of ursodeoxycholic acid on long-term outcome of primary biliary cirrhosis has not been completely elucidated.
Dr Albert Parés and colleagues from Spain assessed the course and survival of patients with primary biliary cirrhosis treated with ursodeoxycholic acid.
The research team compared this with the survival predicted by the Mayo model and the estimated survival of a standardized population.
The team evaluated 192 patients, of which 181 were women, with primary biliary cirrhosis treated with ursodeoxycholic acid 15 mg/kg per day for 1.5 to 14 years.
Response to treatment was defined by an alkaline phosphatase decrease greater than 40% of baseline values or normal levels after 1 year of treatment.
|61% of patients responded to treatment|
The predicted survival was obtained by the Mayo model and the estimated survival was taken from the standardized matched Spanish population.
The researchers found that 9% of patients that died fulfilled criteria for liver transplantation.
The observed survival was higher than that predicted by the Mayo model and lower than that of the control population.
The team observed that 61% of patients responded to treatment.
The survival of responders was significantly higher than that predicted by the Mayo model and similar to that estimated for the control population.
By contrast, the survival of patients without biochemical response was lower than that estimated for the Spanish population.
However, the team noted that survival was higher than that predicted by the Mayo model.
Dr Parés's team concluded, “Biochemical response to ursodeoxycholic acid after 1 year is associated with a similar survival to the matched control population, clearly supporting the favorable effects of this treatment in primary biliary cirrhosis.”
“The suboptimal survival of nonresponders identifies the group for further treatments.”