Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients with Primary Biliary Cholangitis
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Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients with Primary Biliary Cholangitis. / Efe, Cumali; Taşçilar, Koray; Henriksson, Ida; Lytvyak, Ellina; Alalkim, Fatema; Trivedi, Hirsh; Eren, Fatih; Eliasson, Johanna; Beretta-Piccoli, Benedetta Terziroli; Fischer, Janett; Calişkan, Ali Riza; Chayanupatkul, Maneerat; Coppo, Claudia; Ytting, Henriette; Purnak, Tugrul; Muratori, Luigi; Werner, Mårten; Muratori, Paolo; Rorsman, Fredrik; Önnerhag, Kristina; Günşar, Fulya; Nilsson, Emma; Heurgué-Berlot, Alexandra; Güzelbulut, Fatih; Demir, Nurhan; Gönen, Can; Semela, David; Aladaǧ, Murat; Kiyici, Murat; Schiano, Thomas D.; Montano-Loza, Aldo J.; Berg, Thomas; Ozaslan, Ersan; Yoshida, Eric M.; Bonder, Alan; Marschall, Hanns Ulrich; Wahlin, Staffan.
I: American Journal of Gastroenterology, Bind 114, Nr. 7, 07.2019, s. 1101-1108.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients with Primary Biliary Cholangitis
AU - Efe, Cumali
AU - Taşçilar, Koray
AU - Henriksson, Ida
AU - Lytvyak, Ellina
AU - Alalkim, Fatema
AU - Trivedi, Hirsh
AU - Eren, Fatih
AU - Eliasson, Johanna
AU - Beretta-Piccoli, Benedetta Terziroli
AU - Fischer, Janett
AU - Calişkan, Ali Riza
AU - Chayanupatkul, Maneerat
AU - Coppo, Claudia
AU - Ytting, Henriette
AU - Purnak, Tugrul
AU - Muratori, Luigi
AU - Werner, Mårten
AU - Muratori, Paolo
AU - Rorsman, Fredrik
AU - Önnerhag, Kristina
AU - Günşar, Fulya
AU - Nilsson, Emma
AU - Heurgué-Berlot, Alexandra
AU - Güzelbulut, Fatih
AU - Demir, Nurhan
AU - Gönen, Can
AU - Semela, David
AU - Aladaǧ, Murat
AU - Kiyici, Murat
AU - Schiano, Thomas D.
AU - Montano-Loza, Aldo J.
AU - Berg, Thomas
AU - Ozaslan, Ersan
AU - Yoshida, Eric M.
AU - Bonder, Alan
AU - Marschall, Hanns Ulrich
AU - Wahlin, Staffan
PY - 2019/7
Y1 - 2019/7
N2 - INTRODUCTION:Risk stratification based on biochemical variables is a useful tool for monitoring ursodeoxycholic acid (UDCA)-treated patients with primary biliary cholangitis (PBC). Several UDCA response criteria and scoring systems have been proposed for risk prediction in PBC, but these have not been validated in large external cohorts.METHODS:We performed a study on data of 1746 UDCA-treated patients with PBC from 25 centers in Europe, United States, and Canada. The prognostic performance of the risk scoring systems (GLOBE and UK-PBC) and the UDCA response criteria (Barcelona, Paris I, Paris II, Rotterdam, and Toronto) were evaluated. We regarded cirrhosis-related complications (ascites, variceal bleeding, and/or hepatic encephalopathy) as clinical end points.RESULTS:A total of 171 patients reached a clinical end point during a median 7 years (range 1-16 years) of follow-up. The 5-, 10- and 15-year adverse outcome-free survivals were 95%, 85%, and 77%. The GLOBE and UK-PBC scores predicted cirrhosis-related complications better than the UDCA response criteria. The hazard ratio (HR) for a 1 standard deviation increase was HR 5.05 (95% confidence interval (CI): 4.43-5.74, P < 0.001) for the GLOBE score and HR 3.39 (95% CI: 3.10-3.72, P < 0.001) for the UK-PBC score. Overall, the GLOBE and UK-PBC risk scores showed similar and excellent prognostic performance (C-statistic, 0.93; 95% CI: 0.91%-95% vs 0.94; 95% CI: 0.91%-0.96%).DISCUSSION:In our international, multicenter PBC cohort, the GLOBE and UK-PBC risk scoring systems were good predictors of future cirrhosis-related complications.
AB - INTRODUCTION:Risk stratification based on biochemical variables is a useful tool for monitoring ursodeoxycholic acid (UDCA)-treated patients with primary biliary cholangitis (PBC). Several UDCA response criteria and scoring systems have been proposed for risk prediction in PBC, but these have not been validated in large external cohorts.METHODS:We performed a study on data of 1746 UDCA-treated patients with PBC from 25 centers in Europe, United States, and Canada. The prognostic performance of the risk scoring systems (GLOBE and UK-PBC) and the UDCA response criteria (Barcelona, Paris I, Paris II, Rotterdam, and Toronto) were evaluated. We regarded cirrhosis-related complications (ascites, variceal bleeding, and/or hepatic encephalopathy) as clinical end points.RESULTS:A total of 171 patients reached a clinical end point during a median 7 years (range 1-16 years) of follow-up. The 5-, 10- and 15-year adverse outcome-free survivals were 95%, 85%, and 77%. The GLOBE and UK-PBC scores predicted cirrhosis-related complications better than the UDCA response criteria. The hazard ratio (HR) for a 1 standard deviation increase was HR 5.05 (95% confidence interval (CI): 4.43-5.74, P < 0.001) for the GLOBE score and HR 3.39 (95% CI: 3.10-3.72, P < 0.001) for the UK-PBC score. Overall, the GLOBE and UK-PBC risk scores showed similar and excellent prognostic performance (C-statistic, 0.93; 95% CI: 0.91%-95% vs 0.94; 95% CI: 0.91%-0.96%).DISCUSSION:In our international, multicenter PBC cohort, the GLOBE and UK-PBC risk scoring systems were good predictors of future cirrhosis-related complications.
UR - http://www.scopus.com/inward/record.url?scp=85069274453&partnerID=8YFLogxK
U2 - 10.14309/ajg.0000000000000290
DO - 10.14309/ajg.0000000000000290
M3 - Journal article
C2 - 31241547
AN - SCOPUS:85069274453
VL - 114
SP - 1101
EP - 1108
JO - The American Journal of Gastroenterology
JF - The American Journal of Gastroenterology
SN - 0002-9270
IS - 7
ER -
ID: 239016050