Re: Improved prognosis of PBC w biochemical response to urso

[Guest guest]

It might have been coincidental but when the Doctor at hopkins took

my off Urso beause he was an exprt and there was no way I had PSC, my

ALP shot up very quickly and when my PCP had the biopsy done that

siad yet again that I did have PSC and the new Hepatologist at

University of land put me back on Urso my ALP dropped very

quickly.

I think it would be a very interesting study.

Dawn

>

> Gastroenterology [in Press] (2009)

>

> Improved prognosis of patients with Primary Biliary Cirrhosis that

> have a biochemical response to ursodeoxycholic acid.

>

> Edith M.M. Kuiper1, Bettina E. Hansen12, A. de Vries3,

Jannie

> W. den Ouden-Muller4, Theo J.M. van Ditzhuijsen5, Els B. Haagsma6,

> H.M.G. Houben7, Ben J.M. Witteman8, Karel J. van Erpecum9,

> Henk R. van Buuren1, for the Dutch PBC study group

>

> Background and Aims

>

> Ursodeoxycholic Acid (UDCA) improves laboratory liver tests in

> patients with Primary Biliary Cirrhosis (PBC). Few studies have

> assessed prognostic significance of biochemical data collected

> following UDCA treatment. We performed a prospective, multicenter

> study of PBC patients treated with UDCA to compare prognosis with

> biochemical response.

>

> Methods

>

> PBC was classified as early (pre-treatment bilirubin and albumin

> levels normal), moderately advanced (one abnormal) or advanced

(both

> abnormal). Biochemical response was defined as proposed by Pares

> (decrease in alkaline phosphatase [ALP] levels >40% of baseline or

> normal levels), Corpechot (CO: ALP<3-fold the upper limit of normal

> [uLN]; aspartate aminotransferase levels <2-fold the ULN,

bilirubin<1-

> fold the ULN) and our group (RD: normalization of abnormal

bilirubin

> and/or albumin).

>

> Results

>

> The study included 375 patients and median follow-up time was 9.7

> (1.0-17.3) years. The prognosis for early PBC was comparable with

> that of the Dutch population and better than predicted by Mayo risk

> score. Survival of responders was better than of non-responders,

> according to CO and RD criteria (p<0.001). Prognosis of early PBC

was

> comparable for responders and non-responders; prognosis of

responders

> was significantly better in those with(moderately) advanced disease.

>

> Conclusions

>

> Prognosis for UDCA-treated patients with early PBC is comparable to

> that of the general population. Survival of those with advanced PBC

> with biochemical response to UDCA is significantly better than for

> non-responders. Thus, UDCA may be of benefit irrespective of the

> stage of disease. Prognostic information, based on bilirubin and

> albumin levels, is superior to that provided by ALP levels.

>

> Keywords: Primary Biliary Cirrhosis, PBC, UDCA, prognosis,

> biochemical response

> ________________________________

>

> I'd really like to see this kind of analysis done with PSC!

>

> Dave

> (father of (23); PSC 07/03; UC 08/03)

>

[Guest guest]

This was one of the studies discussed when I was taken off Urso (I'm

back on reduced dose now). I had suggested that the stage of PSC was

not addressed in the Lindor study. My hep mentioned the PBC study

results showed more benefit for early stage than late PBC, and that it

might also be true for PSC.

Arne

Gastroenterology [in Press] (2009)

....Prognosis for UDCA-treated patients with early PBC is comparable to

that of the general population...