ArticleThe American journal of gastroenterology2018
Major Hepatic Complications in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis: Risk Factors and Time Trends in Incidence and Outcome.
Article in The American journal of gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 85 citations in OpenAlex.
- Epidemiology and clinical course of primary biliary cholangitis in the Asia-Pacific region: a systematic review and meta-analysis.Hepatology international · 2019Pooled it
- Ursodeoxycholic Acid Use After Bariatric Surgery: Effects on Metabolic and Inflammatory Blood Markers.Obesity surgery · 2023Trial
- Real-world treatment patterns and clinical outcomes of patients with primary biliary cholangitis in the United States.Journal of comparative effectiveness research · 2026Article
- Austrian Society of Gastroenterology and Hepatology (ÖGGH) consensus on primary biliary cholangitis.Wiener klinische Wochenschrift · 2026Article
- Steatotic Liver Disease at Primary Biliary Cholangitis Diagnosis: Association With Ursodeoxycholic Acid Response and Outcomes.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Economic Burden of Primary Biliary Cholangitis by Line of Therapy in the United States.Advances in therapy · 2026Article
- The bile acid-gut microbiota-vitamin D axis: new insights into biliary atresia.Frontiers in cellular and infection microbiology · 2026Review
- The Personalized Management of Primary Biliary Cholangitis in the Era of Precision Medicine: Current Challenges and Future Perspectives.Journal of personalized medicine · 2025Review
- Effect of rapamycin nanoparticles in an animal model of primary biliary cholangitis.World journal of hepatology · 2025Article
- Primary biliary cholangitis. Treatment options in 2025. A narrative review.Frontiers in immunology · 2025Review
- Type of calcineurin inhibitor and long-term outcomes following liver transplantation in patients with primary biliary cholangitis - an ELTR study.JHEP reports : innovation in hepatology · 2024Article
- Article
- Noninvasive prediction of insufficient biochemical response after ursodeoxycholic acid treatment in patients with primary biliary cholangitis based on pretreatment nonenhanced MRI.European radiology · 2024Article
- Developing a Prognostic Model for Primary Biliary Cholangitis Based on a Random Survival Forest Model.International journal of medical sciences · 2024Article
- Prognostic scores in primary biliary cholangitis.Future science OA · 2024Article
- Efficacy and safety of peroxisome proliferator-activated receptor agonists for the treatment of primary biliary cholangitis: a meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2024Review
- Two Decades of Liver Transplants for Primary Biliary Cholangitis: A Comparative Study of Living Donors vs. Deceased Donor Liver Transplantations.Journal of clinical medicine · 2023Article
- Plasma lipidomics of primary biliary cholangitis and its comparison with Sjögren's syndrome.Frontiers in immunology · 2023Article
- Distinct prognostic value of different portal hypertension-associated features in patients with primary biliary cholangitis.Journal of gastroenterology · 2022Article
- Lathyrane Diterpenoids as Novel hPXR Agonists: Isolation, Structural Modification, and Structure-Activity Relationships.ACS medicinal chemistry letters · 2021Article
Corrections and comments
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Authors and funding
23 authors at 17 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIn this era of near universal ursodeoxycholic acid (UDCA) treatment for primary biliary cholangitis (PBC), progression to cirrhosis still occurs in an important proportion of patients. The aim of this study was to describe the incidence of cirrhosis-associated complications in patients with PBC and assess risk factors and impact on survival.
methodsCohorts of UDCA-treated patients from 16 European and North-American liver centers were included. We used Cox proportional hazards assumptions and Kaplan-Meier estimates.
resultsDuring 8.1 years' median follow-up, 278 of 3,224 patients developed ascites, variceal bleeding, and/or encephalopathy (incidence rate of 9.7 cases/1,000 patient years). The overall cumulative incidence was 9.1% after 10 years of follow-up, but decreased over time to 5.8% after the year 2000. Earlier calendar year of diagnosis (P<0.001), high aspartate aminotransferase to platelets ratio index (APRI; P<0.001) and biochemical non-response (P<0.001) were independently associated with future complications. Patients with both biochemical non-response and an APRI >0.54 after 12 months of UDCA had a 10-year complication rate of 37.4%, as compared to 3.2% in biochemical responders with an APRI ≤0.54. The 10-year transplantation-free survival after a complication was 9% (time-dependent hazard ratio 21.5; 20.1-22.8). Prognosis after variceal bleeding has improved over time.
conclusionsIn this large international cohort, up to 15% of UDCA-treated PBC patients developed major non-neoplastic, cirrhosis-associated hepatic complications within 15 years, but cumulative incidence has decreased over time. Biochemical non-response to UDCA and APRI were independent risk factors for these complications. Subsequent long-term outcome after complications is generally poor, but has improved over the past decades.
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