{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:27:54Z","timestamp":1791239274399,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":2556,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,9]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Biochemical response to ursodeoxycholic acid (UDCA) in patients with primary biliary cirrhosis (PBC) is variable. It has been recently proposed that an alkaline phosphatase (ALP) decline of more than 40% in baseline value or a normal level after 1 year of UDCA treatment (Barcelona criteria) could serve as a good marker of long-term prognosis. Our aim was to define the best efficient set of biochemistries able to identify UDCA-treated patients at risk of death or liver transplantation (LT). The efficiency of several combinations of serum bilirubin, ALP, and aspartate aminotransferase (AST) threshold values to predict outcome was assessed after 1 year of treatment in 292 patients with PBC. Patients showing ALP &lt;3 upper limit of normal (ULN), AST &lt;2 ULN, and bilirubin \u22641 mg\/dL after 1 year of UDCA had a 10-year transplant-free survival rate of 90% (95% confidence interval, 81%\u201395%), compared to 51% (95% confidence interval, 38%\u201364%) for those who did not (<\/jats:bold>\n                      <jats:bold>P<\/jats:bold>\n                      <jats:bold>&lt; 0.001). Patients were less well discriminated by the Barcelona criteria (79% versus 63%). Independent predictive factors of death or LT were baseline serum bilirubin level &gt;1 mg\/dL (relative risk [RR], 1.7), histologic stage \u22653 (RR, 1.5), interface hepatitis (RR, 1.9), and the absence of biochemical response (ALP &gt;3 ULN or AST &gt;2 ULN, or bilirubin &gt;1 mg\/dL) (RR, 2.3). Antinuclear antibodies against gp210 or Sp100 proteins were associated with death or LT in univariate but not in multivariate analysis.<\/jats:bold>\n                      <jats:bold>Conclusion:<\/jats:bold>\n                      <jats:bold>This study defines the best efficient biochemical response to UDCA, which, independent of baseline predictive factors, identifies patients with PBC with a good long-term prognosis. Patients who fail to achieve this response and those with interface hepatitis or advanced histological stage should be targeted for further therapeutic research. (Hepatology 2008.)<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.22428","type":"journal-article","created":{"date-parts":[[2008,5,30]],"date-time":"2008-05-30T14:16:56Z","timestamp":1212157016000},"page":"871-877","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":593,"title":["Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis"],"prefix":"10.1097","volume":"48","author":[{"given":"Christophe","family":"Corpechot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovico","family":"Abenavoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabila","family":"Rabahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Chr\u00e9tien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Andr\u00e9ani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Johanet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Chazouill\u00e8res","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raoul","family":"Poupon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20-20241202","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1056\/NEJM199105303242204","article-title":"A multicenter, controlled trial of ursodiol for the treatment of primary biliary cirrhosis.","volume":"324","author":"Poupon","year":"1991","journal-title":"N Engl J Med"},{"key":"R2-20-20241202","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/0016-5085(94)90021-3","article-title":"Ursodeoxycholic acid in the treatment of primary biliary cirrhosis.","volume":"106","author":"Lindor","year":"1994","journal-title":"Gastroenterology"},{"key":"R3-20-20241202","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1002\/hep.1840190512","article-title":"The Canadian Multicenter Doubleblind Randomized Controlled Trial of Ursodeoxycholic Acid in Primary Biliary Cirrhosis.","volume":"19","author":"Heathcote","year":"1994","journal-title":"HEPATOLOGY"},{"key":"R4-20-20241202","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/S0016-5085(97)70183-5","article-title":"Combined analysis of randomized controlled trials of ursodeoxycholic acid in primary biliary cirrhosis.","volume":"113","author":"Poupon","year":"1997","journal-title":"Gastroenterology"},{"key":"R5-20-20241202","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/S0168-8278(03)00192-2","article-title":"Combined analysis of the effect of treatment with ursodeoxycholic acid on histologic progression in primary biliary cirrhosis.","volume":"39","author":"Poupon","year":"2003","journal-title":"J Hepatol"},{"key":"R6-20-20241202","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1002\/hep.510290603","article-title":"Tenyear survival in ursodeoxycholic acidtreated patients with primary biliary cirrhosis. The UDCAPBC Study Group.","volume":"29","author":"Poupon","year":"1999","journal-title":"Hepatology"},{"key":"R7-20-20241202","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1023\/B:DDAS.0000037811.48575.da","article-title":"Survival of antimitochondrial antibodypositive and negative primary biliary cirrhosis patients on ursodeoxycholic acid treatment.","volume":"49","author":"Koulentaki","year":"2004","journal-title":"Dig Dis Sci"},{"key":"R8-20-20241202","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1053\/j.gastro.2005.12.029","article-title":"Excellent longterm survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic acid.","volume":"130","author":"Pares","year":"2006","journal-title":"Gastroenterology"},{"key":"R9-20-20241202","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1111\/j.1572-0241.2006.00699.x","article-title":"Prognosis of ursodeoxycholic acidtreated patients with primary biliary cirrhosis. Results of a 10yr cohort study involving 297 patients.","volume":"101","author":"ter Borg","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"R10-20-20241202","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1053\/j.gastro.2004.11.009","article-title":"The effect of ursodeoxycholic acid therapy on the natural course of primary biliary cirrhosis.","volume":"128","author":"Corpechot","year":"2005","journal-title":"Gastroenterology"},{"key":"R11-20-20241202","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1002\/hep.510290140","article-title":"Clinical significance of serum bilirubin levels under ursodeoxycholic acid therapy in patients with primary biliary cirrhosis.","volume":"29","author":"Bonnand","year":"1999","journal-title":"HEPATOLOGY"},{"key":"R12-20-20241202","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1053\/gast.2002.31880","article-title":"Primary biliary cirrhosis: incidence and predictive factors of cirrhosis development in ursodioltreated patients.","volume":"122","author":"Corpechot","year":"2002","journal-title":"Gastroenterology"},{"key":"R13-20-20241202","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/hep.510280203","article-title":"Primary biliary cirrhosisautoimmune hepatitis overlap syndrome: clinical features and response to therapy.","volume":"28","author":"Chazouilleres","year":"1998","journal-title":"HEPATOLOGY"},{"key":"R14-20-20241202","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/BF00432479","article-title":"Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis).","volume":"379","author":"Ludwig","year":"1978","journal-title":"Virchows Arch A Pathol Anat Histol"},{"key":"R15-20-20241202","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1002\/hep.510230512","article-title":"Specificity and sensitivity of gp210 autoantibodies detected using an enzymelinked immunosorbent assay and a synthetic polypeptide in the diagnosis of primary biliary cirrhosis.","volume":"23","author":"Bandin","year":"1996","journal-title":"HEPATOLOGY"},{"key":"R16-20-20241202","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1016\/S0016-5085(96)70051-3","article-title":"Survival in ursodeoxycholic acidtreated patients with primary biliary cirrhosis.","volume":"111","author":"Lindor","year":"1996","journal-title":"Gastroenterology"},{"key":"R17-20-20241202","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0140-6736(05)72401-6","article-title":"Ursodeoxycholic acid for primary biliary cirrhosis.","volume":"355","author":"Lindor","year":"2000","journal-title":"Lancet"},{"key":"R18-20-20241202","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1111\/j.1572-0241.2006.00634.x","article-title":"Longterm effects of middose ursodeoxycholic acid in primary biliary cirrhosis: a metaanalysis of randomized controlled trials.","volume":"101","author":"Shi","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"R19-20-20241202","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1136\/gut.20.2.137","article-title":"Serum bilirubin: a prognostic factor in primary biliary cirrhosis.","volume":"20","author":"Shapiro","year":"1979","journal-title":"Gut"},{"key":"R20-20-20241202","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1002\/hep.510300415","article-title":"Is serum bilirubin concentration the only valid prognostic marker in primary biliary cirrhosis?","volume":"30","author":"Krzeski","year":"1999","journal-title":"HEPATOLOGY"},{"key":"R21-20-20241202","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.1478-3231.2004.0918.x","article-title":"Biochemical markers of liver fibrosis and lymphocytic piecemeal necrosis in UDCAtreated patients with primary biliary cirrhosis.","volume":"24","author":"Corpechot","year":"2004","journal-title":"Liver Int"},{"key":"R22-20-20241202","first-page":"466A","article-title":"Are antinuclear antibody markers early predictors of more active primary biliary cirrhosis?","volume":"42","author":"Corpechot","year":"2005","journal-title":"HEPATOLOGY"},{"key":"R23-20-20241202","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/j.1572-0241.2003.07257.x","article-title":"Characterization and clinical impact of antinuclear antibodies in primary biliary cirrhosis.","volume":"98","author":"Muratori","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"R24-20-20241202","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1136\/gut.2003.036558","article-title":"Prevalence and clinical significance of isotype specific antinuclear antibodies in primary biliary cirrhosis.","volume":"54","author":"Rigopoulou","year":"2005","journal-title":"Gut"},{"key":"R25-20-20241202","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1002\/hep.21172","article-title":"Correlation of initial autoantibody profile and clinical outcome in primary biliary cirrhosis.","volume":"43","author":"WesierskaGadek","year":"2006","journal-title":"HEPATOLOGY"},{"key":"R26-20-20241202","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1055\/s-2005-916321","article-title":"Antinuclear antibodies in primary biliary cirrhosis.","volume":"25","author":"Invernizzi","year":"2005","journal-title":"Semin Liver Dis"},{"key":"R27-20-20241202","first-page":"550A","article-title":"Progression in PBC: new insights from followup liver biopsies 10 years after diagnosis.","volume":"46","author":"Kumagi","year":"2007","journal-title":"HEPATOLOGY"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.22428","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-200809000-00020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T12:04:51Z","timestamp":1733141091000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-200809000-00020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,9]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2008]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.22428","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2008,9]]}}}