{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T21:49:34Z","timestamp":1782510574455,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Optimal care delivery for primary biliary cholangitis (PBC) has become challenging due to new therapies and more individualized biochemical treatment goals.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To evaluate uptake of ursodeoxycholic acid (UDCA) and second\u2010line therapy (SLT) in a nationwide PBC cohort and identify factors associated with suboptimal therapeutical management.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The Dutch PBC Cohort Study is a retrospective study including every identifiable patient with PBC in the Netherlands from 1990 onwards. Use of UDCA and SLT was assessed among patients in clinical follow\u2010up on 1 January 2019. Biochemical response was defined as alkaline phosphatase (ALP) and aspartate aminotransferase (AST) \u2264\u20091.5 \u00d7 ULN and total bilirubin (TB)\u2009\u2264\u2009ULN. SLT included off\u2010label fibrates, budesonide and\/or obeticholic acid (not reimbursed).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 2638 patients with PBC were included; median age was 64.0 (IQR 55.0\u201372.0) years, 2361 (89.5%) were female and 2143 (81.2%) were treated in a non\u2010academic center. Overall, 2532 (96.0%) patients used UDCA. The recommended UDCA dose of \u2265\u200913\u2009mg\/kg\/day was used by 1363\/2205 (61.8%). Age (aOR 1.01, 95% CI 1.00\u20131.02,\n p<\/jats:italic>\n \u2009=\u20090.02), body weight (aOR 1.04, 95% CI 1.03\u20131.05,\n p<\/jats:italic>\n \u2009<\u20090.01) and biochemical response (aOR 1.35, 95% CI 1.09\u20131.67,\n p<\/jats:italic>\n \u2009=\u20090.01) were associated with UDCA dosage <\u200913\u2009mg\/kg\/day. Among patients with an incomplete response, 101\/638 (15.8%) were prescribed SLT. Younger age, female sex, treatment in an academic centre and higher levels of ALP and AST were positively associated with use of SLT.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n During recent years, UDCA was insufficiently dosed in Dutch patients with PBC. The results indicate that first\u2010line treatment can be optimized, especially in those with a biochemical response and higher body weight.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apt.70669","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:29:53Z","timestamp":1776173393000},"page":"186-195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Nationwide Assessment of Anticholestatic Therapy Uptake in Patients With Primary Biliary Cholangitis: Opportunities for Optimisation"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9410-781X","authenticated-orcid":false,"given":"Ellen","family":"Werner","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C. B.","family":"van Hooff","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma H. X.","family":"Weijsters","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"van de Vrie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1604-0931","authenticated-orcid":false,"given":"Rozanne C.","family":"de Veer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Beuers","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8027-3073","authenticated-orcid":false,"given":"Joost P. H.","family":"Drenth","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans J. C.","family":"Cuperus","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remco","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart J.","family":"Veldt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Reinier de Graaf Gasthuis Delft the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Klemt\u2010Kropp","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Noordwest Ziekenhuisgroep Alkmaar the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"van Meer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5591-0499","authenticated-orcid":false,"given":"Robert C.","family":"Verdonk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology St. Antonius Hospital Nieuwegein the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajo J.","family":"Flink","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Catharina Hospital Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Maarten","family":"Vrolijk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Arnhem the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6248-8345","authenticated-orcid":false,"given":"Matthijs","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Maastricht University Medical Center Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyriel Y.","family":"Ponsioen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Boonstra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Radboud University Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke","family":"Boersma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Gelre Hospitals Apeldoorn the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik J. 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