S1131 Sociodemographic Determinants of Response to Ursodiol: Is Age a Predictor of Ursodiol Non-Response?
Bibliographic record
Abstract
Introduction: Primary biliary cholangitis (PBC) is a chronic autoimmune disorder characterized by portal inflammation and intrahepatic biliary duct destruction. Ursodiol is the first-line treatment for many patients with PBC. The primary aim of this study is to assess the role of socio-demographic variables on response to ursodiol elicited by Toronto criteria, which has been validated in previous studies. Methods: A retrospective cohort study was conducted at Liver Associates of Texas Hepatology outpatient clinics in Houston, Texas. All patients diagnosed with PBC from January 2018-May 2021 were included. Lab and Fibroscan results before and 1 year after starting ursodiol in these patients were collected from their records. Response to Ursodiol was measured using the Toronto criteria [alkaline phosphatase (ALP)≤1.67 times upper limit of normal (ULN) are responders and ALP >1.67 times ULN are non-responders]. Continuous variables were compared with either the Student’s T-test or Wilcoxon Rank-sum test. Chi-square test, Fisher’s exact test and logistic regression were used for categorical variables. Significance level was set at 5%. Results: Data for ursodiol response was available for 111/136 patients with PBC and included in the study. 65/111 (58.6%) were ursodiol responders and 46/111 (41.4%) were ursodiol non-responders. Majority of the patients were female with no significant difference in gender [p=0.191] distribution. Overall, 36.8% are White, 14.7% are Hispanic, 12.5% are African American, 3.7% are Asian, 2.2% are Native American, and 30.2% are of unspecified race, with no significant difference among responders vs non-responders [p=0.290] with respect to ethnicity. The median age for responders is 67 years and 61.5 years for non-responders, which was significantly different between the two groups [p=0.004]. On logistic regression, PBC patients ≤ 55 years of age have 2.62 times higher risk of non-response to ursodiol compared to patients > 55 years of age [OR=2.62, p=0.034]. On univariate analysis, BMI [p=0.434], gender [p=0.191], and PBC-AIH overlap syndrome [p=0.717] were not significantly different among ursodiol responders vs non-responders. Conclusion: PBC patients younger than or equal to 55 years of age are at a higher risk of non-response to ursodiol than PBC patients >55 years, thus need effective monitoring for their response to ursodiol. Further studies are needed to validate age as a predictor of ursodiol response in PBC patients.Table 1.: Prevalence of documented immunity to or vaccination for HAV and HBV among adults with chronic liver disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".