{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:27:23Z","timestamp":1790263643814,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>The relationship between primary biliary cholangitis (PBC) and metabolic dysfunction\u2010associated steatotic liver disease, and its impact on treatment response and prognosis, remains underexplored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patient cohort from two centres comprising long\u2010term follow\u2010up data. All patients had histologically confirmed PBC. Biopsies were classified according to Non\u2010Alcoholic Steatohepatitis Clinical Research Network. Diagnosis of metabolic dysfunction\u2010associated steatotic liver disease was established when steatosis exceeded 5%, along with at least one metabolic risk factor. Patients with specific aetiologies of steatosis, other liver diseases, incomplete results and inadequate treatment with ursodeoxycholic acid were excluded. Data from patients initiating second\u2010line treatment were censored. Treatment response was assessed using the Toronto, Paris II and AST\u2010to\u2010platelet at 12\u2010month criteria. The UK PBC and Globe scores, and liver events were utilized as outcome measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 129 patients, 36 showing histologically confirmed overlap between PBC and steatosis. Patients with overlap showed worse prognosis according to Paris II (61.1% vs. 33.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.004), Toronto (52.5% vs. 24.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), AST\u2010to\u2010platelet 12\u2010month &gt;0.54 (36.1% vs. 17.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.021), Globe &gt;0.30 (49.2% vs. 29.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.033) and UK PBC at 5, 10 and 15\u2009years (<jats:italic>p<\/jats:italic>\u2009\u2264\u20090.001). Liver\u2010related mortality and liver transplant were more prevalent in the overlap group (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). In the multivariate analysis, steatosis, dyslipidaemia and advanced fibrosis were independently associated to worse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that metabolic dysfunction\u2010associated steatotic liver disease worsens the prognosis of PBC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18134","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T07:55:43Z","timestamp":1719302143000},"page":"613-619","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The overlap with metabolic dysfunction\u2010associated steatotic liver disease negatively affects outcomes of primary biliary cholangitis"],"prefix":"10.1111","volume":"60","author":[{"given":"Mar\u00eda","family":"Hern\u00e1ndez\u2010P\u00e9rez","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Department La Paz University Hospital  Madrid 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