P-103 AN ELEVATED BASELINE LEVEL OF ALKALINE PHOSPHATASE, ALANINE AMINOTRANSFERASE, AND ASPARTATE AMINOTRANSFERASE PREDICT A LACK OF BIOCHEMICAL RESPONSE TO UDCA THERAPY AMONG HISPANIC PATIENTS LIVING WITH PRIMARY BILIARY CHOLANGITIS
Notice bibliographique
Résumé
No Primary biliary cholangitis (PBC) is a chronic, progressive, autoimmune liver disease characterized by the destruction of the small bile ducts within the liver. Ursodeoxycholic acid (UDCA) is the first-line treatment for PBC, shown to improve liver biochemistry and delay disease progression. However, the response to UDCA therapy is variable among patients, with some failing to achieve a satisfactory biochemical response. Identifying predictors of non-response is crucial for optimizing treatment strategies and improving patient outcomes. Recent evidence has shown a lower biochemical response among patients of Hispanic ethnicity, which is often underrepresented in clinical research. The findings have significant implications for clinical practice, and are of particular interest in countries that have limited access to liver transplantation. This is a single center, retrospective, propensity score-matched cohort study, which included all patients with PBC confirmed by liver biopsy that were followed by the hepatology clinic from January 1 st , 2015 to March 1 st 2024 under treatment with UDCA. A biochemical response was defined according to the Toronto criteria, with an alkaline phosphatase (ALP) <1.67 x ULN after 2 years of UDCA therapy. Patients were subdivided on the presence or absence of a biochemical response. The primary outcome was mortality due to a liver related event (LRE), the secondary outcomes were variables associated with non-response. A total of 132 patients were included, 70 were non responders and 62 fulfilled Toronto criteria of response. The predominant gender was female in both groups (96.78% and 96%) with a median of 56 years of age for the non-responders and 58 years for those who did. Mortality due to LRE in the no response vs responders group was 41% vs 6.2%, respectively, a difference which was statistically significant (OR 3.67, 95% CI [1.608, 8.411], p<0.001). Factors associated with incomplete response were statistically significant for a baseline level of ALP > 2 x ULN (OR 5.3, 95% CI [2.433, 11.649], p<0.001), a baseline level of ALT > ULN (OR 5.3, 95% CI [2.429, 11.845], p<0.001) and a baseline level of AST > ULN (OR 7.8, 95% CI [3.554, 17.159] p<0.001). All of these variables remained ss after multivariate regression analysis. Among patients with PBC that receive initial therapy with UDCA, a baseline increased ALP, AST and ALT are associated with an incomplete biochemical response, identifying patients that might benefit from early initiation of additional therapies. Prospective studies are needed.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».