Prognostic scores in primary biliary cholangitis

Figures & data

Figure 1. Flowchart of patient selection and outcomes.

PBC: Primary biliary cholangitis; UDCA: Ursodeoxycholic acid.

Table 1. Patients' characteristics and pre-treatment lab data.

Parameter		All patients (n = 50)
Age at diagnosis (years)	Median (IQR)	56 (18)
Females/males	n (%)	49 (98)/1 (2)
Associated AIH	n (%)	10 (20)
Cirrhosis at diagnosis	n (%)	19 (38)
Decompensated cirrhosis at diagnosis	n (%)	10 (52.6% of cirrhosis)
PLT (10∧9/l)	Mean ± SD	194.755 ± 95.815
AST (UI/l)	Median (IQR)	58 (50)
ALT (UI/l)	Median (IQR)	49 (45)
GGT (UI/l)	Median (IQR)	152 (248)
ALP (UI/l)	Median (IQR)	298 (368)
TB (μmol/l)	Median (IQR)	12 (15)
Alb (g/l)	Mean ± SD	34.3 ± 8.2
PT (%)	Median (IQR)	91 (23)
Treatment responders	n (%)	32 (64)
Follow-up (months)	Median (IQR)	76 (80)
Liver cirrhosis complications	n (%)	20 (40%)

AIH: Autoimmune hepatitis; Alb: Albumin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aaspartate aminotransferase; GGT: Gamma-glutamyl transferase; IQR: Inter quartile range; PLT: Platelet count; PT: Prothrombin time; TB: Total bilirubin.

Table 2. Differences in patients' characteristics and pre-treatment lab data between responders and non-responders.

Parameter		Responders (n = 32, 64%)	Non-responders (n = 18, 36%)	p-value
Age at diagnosis <50 years	n (%)	10 (31.3)	5 (27.8)	0.797
Females/males	n (%)	32 (100)/0	17 (94.4)/1 (5.6)	0.360
Associated AIH	n (%)	7 (21.9)	3 (16.7)	0.479
Cirrhosis at diagnosis	n (%)	5 (15.6)	14 (77.8)	<0.001
PLT (10∧9/l)	Mean ± SD	210.580 ± 79.308	167.500 ± 116.528	0.175
AST (UI/l)	Median (IQR)	50 (46)	66.5 (82)	0.199
ALT (UI/l)	Median (IQR)	43 (50)	55.5 (46)	0.363
GGT (UI/l)	Median (IQR)	150 (217)	195 (371)	0.640
ALP (UI/l)	Median (IQR)	285 (291)	413 (488)	0.097
TB (μmol/l)	Median (IQR)	10 (8)	34.4 (52)	<0.001
Alb (g/l)	Mean ± SD	36.6 ± 8.3	30.5 ± 6.6	0.009
PT (%)	Median (IQR)	95.5 (14)	77.5 (30)	0.003

Compared with non-responders, responders to treatment had significantly higher baseline prothrombin time and albumin level and lower bilirubin level, as indicated with the bold values.

Alb: Albumin; AIH: Autoimmune hepatitis; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; AST: Aspartate aminotransferase; GGT: Gamma-glutamyl transferase; IQR: Interquartile range; PLT: Platelet count; PT: Prothrombin time; TB: Total bilirubin.

Figure 2. Liver event-free survival analysis by treatment response, using Kaplan–Meier model and Log-rank test, for PBC patients treated with UDCA.

HR: Hazard ratio; PBC: Primary biliary cholangitis; UDCA: Ursodeoxycholic acid.

Figure 3. ROC curves assessing the discriminatory performance of prognostic scores in predicting biochemical response for primary biliary cholangitis patients treated with ursodeoxycholic acid.

ALBI: Albumin-bilirubin score; APRI: Aspartate aminotransferase to platelet ratio index; AUROC: Area under the curve; BR: Biochemical response; GLOBE: Global Assessment of Liver Outcomes score; PBC: Primary biliary cholangitis; ROC: Receiver operating characteristic; UDCA: Ursodeoxycholic acid; UK-PBC: UK Primary Biliary Cholangitis score.

Figure 4. ROC curves assessing the discriminatory performance of prognostic scores in predicting liver-related events over 5 years, for primary biliary cholangitis patients treated with ursodeoxycholic acid.

ALBI: Albumin-bilirubin score; APRI: Aspartate aminotransferase to platelet ratio index; AUROC: Area under the curve; GLOBE: Global Assessment of Liver Outcomes score; PBC: Primary biliary cholangitis; ROC: Receiver operating characteristic; UDCA: Ursodeoxycholic acid; UK-PBC: UK Primary Biliary Cholangitis score.

Figure 5. Liver event-free survival analysis by APRI 0.54 threshold, using Kaplan–Meier model and Log-rank test, for primary biliary cholangitis patients treated with ursodeoxycholic acid.

APRI: Aspartate aminotransferase to platelet ratio index; HR: Hazard ratio; PBC: Primary biliary cholangitis; UDCA: Ursodeoxycholic acid.

Figure 6. Liver event-free survival analysis by ALBI grades, using Kaplan–Meier model and log-rank test, for primary biliary cholangitis patients treated with ursodeoxycholic acid.

ALBI: Albumin-bilirubin score; CI: Confidence interval; HR: Hazard ratio; PBC: Primary biliary cholangitis; UDCA: Ursodeoxycholic acid.

Figure 7. Liver event-free survival analysis by GLOBE score threshold of 0.30, using Kaplan–Meier model and Log-rank test, for primary biliary cholangitis patients treated with ursodeoxycholic acid.

GLOBE: Global Assessment of Liver Outcomes score; HR: Hazard ratio; PBC: Primary biliary cholangitis; UDCA: Ursodeoxycholic acid.