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Title: Factors Cited In Development Of Cirrhosis In Patients Treated With Ursodeoxycholic Acid

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Gastroenterology 2002; 122: 652-658. "Primary biliary cirrhosis: Incidence and predictive factors of cirrhosis development in ursodiol-treated patients"
04/02/2002 09:03:00 AM
By James Adams

Serum bilirubin and albumin levels and the degree of lymphocytic piecemeal necrosis appear to be predictive of cirrhosis in patients with primary biliary cirrhosis (PBC) treated with ursodeoxycholic acid (UDCA). Serum bilirubin over 17 micromoles/liter, serum albumin below 38 grams/liter and moderate to severe lymphocytic piecemeal necrosis were found to be independent predictive factors for developing cirrhosis in UDCA-treated patients, according to investigators from the Hôpital Saint-Antoine and the Hôpital Necker-Enfant Malades in Paris, France. Incidence of cirrhosis among patients with primary biliary cirrhosis stage I, II and III was 4, 12 and 59 percent respectively after five years of UDCA treatment; after 10 years of treatment the incidence was 17, 27 and 76 percent, respectively. Median time for developing cirrhosis from stages I, II and III was 25, 20 and four years, respectively. The investigators used a Markov model to assess the progression of cirrhosis in 183 PBC patients treated with UDCA, a medication which slows the progression of PBC. They collected 254 pairs of liver biopsies during a period of 665 patient-years. The observations may be useful in the design and evaluation of clinical trials of drugs associated with UDCA, the investigators conclude. This study was supported in part by the Programme Hospitalier de Recherche Clinique, Assistance Publique-Hôpitaux de Paris.

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