{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:38:04Z","timestamp":1791833884105,"version":"4.3.4"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Many children with primary sclerosing cholangitis (PSC) receive oral vancomycin therapy (OVT) or ursodeoxycholic acid (UDCA). There is a paucity of data on whether these medications improve outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>We analyzed retrospective data from the Pediatric PSC Consortium. Children treated with OVT were matched 1:1:1 to those treated with UDCA or managed with observation (no treatment) based on the closest propensity score, ensuring similar baseline characteristics. Two hundred sixty\u2010four patients (88 each with OVT, UDCA, or observation) had matching propensity scores and were similar in demographics, phenotype, immunosuppression, baseline biochemistry, and hepatic fibrosis. After 1 year in an intention\u2010to\u2010treat analysis, all outcome metrics were similar regardless of treatment group. In OVT, UDCA, and untreated groups, respectively: Gamma\u2010glutamyltransferase normalized in 53%, 49%, and 52% (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a0not significant [NS]), liver fibrosis stage was improved in 20%, 13%, and 18% and worsened in 11%, 29%, and 18% (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a0NS), and the 5\u2010year probability of liver transplant listing was 21%, 10%, and 12% (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a0NS). Favorable outcome was associated with having a mild phenotype of PSC and minimal hepatic fibrosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>We presented the largest\u2010ever description of outcomes on OVT in PSC and compared them to carefully matched patients on UDCA or no therapy. Neither OVT nor UDCA showed improvement in outcomes compared to a strategy of observation. Patients progressed to end\u2010stage liver disease at similar rates. Spontaneous normalization of biochemistry is common in children receiving no therapy, particularly in the majority of children with a mild phenotype and an early stage of disease. Placebo\u2010controlled treatment trials are needed to identify effective treatments for pediatric PSC.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31560","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T16:39:23Z","timestamp":1600447163000},"page":"1061-1073","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":93,"title":["Oral Vancomycin, Ursodeoxycholic Acid, or No Therapy for Pediatric Primary Sclerosing Cholangitis: A Matched Analysis"],"prefix":"10.1097","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0459-9404","authenticated-orcid":false,"given":"Mark R.","family":"Deneau","sequence":"first","affiliation":[{"name":"University of Utah and Intermountain Primary Children\u2019s Hospital,Salt Lake City,UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Mack","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine,Aurora,CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Mogul","sequence":"additional","affiliation":[{"name":"Johns Hopkins University,Baltimore,MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily R.","family":"Perito","sequence":"additional","affiliation":[{"name":"University of California, San Francisco,San Francisco,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8227-2004","authenticated-orcid":false,"given":"Pamela L.","family":"Valentino","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine,New Haven,CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achiya Z.","family":"Amir","sequence":"additional","affiliation":[{"name":"The Dana\u2010Dwek Children\u2019s Hospital,The Tel\u2010Aviv Medical Center,Tel\u2010Aviv University,Tel Aviv,Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"DiGuglielmo","sequence":"additional","affiliation":[{"name":"Nemours\/Alfred I. duPont Hospital for Children,Wilmington,DE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura G.","family":"Draijer","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Center,Amsterdam,The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"El\u2010Matary","sequence":"additional","affiliation":[{"name":"University of Manitoba,Winnipeg,Manitoba,Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katryn N.","family":"Furuya","sequence":"additional","affiliation":[{"name":"Mayo Clinic,Rochester,MN"},{"name":"University of Wisconsin\u2013Madison School of Medicine and Public Health,Madison,WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitika","family":"Gupta","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine,Atlanta,GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica T.","family":"Hochberg","sequence":"additional","affiliation":[{"name":"University of Miami,Miami,FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Horslen","sequence":"additional","affiliation":[{"name":"University of Washington,Seattle,WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Kyle","family":"Jensen","sequence":"additional","affiliation":[{"name":"University of Utah and Intermountain Primary Children\u2019s Hospital,Salt Lake City,UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen M.","family":"Jonas","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital and Harvard Medical School,Boston,MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanda","family":"Kerkar","sequence":"additional","affiliation":[{"name":"University of Rochester Medical Center,Rochester,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart G.P.","family":"Koot","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Center,Amsterdam,The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor J.","family":"Laborda","sequence":"additional","affiliation":[{"name":"University of Utah and Intermountain Primary Children\u2019s Hospital,Salt Lake 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