{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T07:42:12Z","timestamp":1722930132062},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T00:00:00Z","timestamp":1520380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ministry of Health, Labor, and Welfare of Japan"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>As primary biliary cholangitis (PBC) is a heterogeneous disease, we hypothesized that there is a population of patients with early PBC who do not require prompt treatment with ursodeoxycholic acid (UDCA). In this study, we analyzed data from a large\u2010scale PBC cohort in Japan, and retrospectively investigated whether outcomes of early PBC patients were affected with prompt or deferred\/no UDCA treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We defined early PBC as asymptomatic, serum alkaline phosphatase &lt;1.67\u2010fold the upper limit of normal, normal bilirubin, and histological stages\u00a0I\u2013II at presentation. We compared the outcomes of early PBC patients between the treatment regimens; prompt treatment group (UDCA was initiated within 1\u00a0year after diagnosis) and deferred\/no treatment group (UDCA initiated &gt;1\u00a0year after diagnosis or never initiated). Furthermore, we examined the outcomes of early PBC patients alternatively defined only with symptomatology and biochemistry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 562 early PBC patients (prompt: <jats:italic>n<\/jats:italic>\u2009=\u2009509; deferred\/no treatment: <jats:italic>n<\/jats:italic>\u2009=\u200953). Incidence rates (per 1000\u00a0patient\u2010years) for liver\u2010related mortality or liver transplantation and decompensating events were 0.5 and 5.4, respectively, in the prompt treatment group, and 0 and 8.7, respectively, in the deferred\/no treatment group. Multivariate analyses showed that age and bilirubin were significantly associated with developing decompensating events, whereas the prompt and deferred\/no treatments were not. We obtained similar results in early PBC patients defined without histological examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We showed that deferred\/no treatment for early PBC patients did not affect the outcomes. This study provides a rationale for a future prospective, randomized study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13068","type":"journal-article","created":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T07:06:55Z","timestamp":1517900815000},"page":"727-734","source":"Crossref","is-referenced-by-count":4,"title":["Effect of deferred or no treatment with ursodeoxycholic acid in patients with early primary biliary cholangitis"],"prefix":"10.1111","volume":"48","author":[{"given":"Atsushi","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of Medicine Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junko","family":"Hirohara","sequence":"additional","affiliation":[{"name":"The Third Department of Internal Medicine Kansai Medical University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Nakano","sequence":"additional","affiliation":[{"name":"The Third Department of Internal Medicine Kansai Medical University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minami","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Medicine Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Namisaki","sequence":"additional","affiliation":[{"name":"The Third Department of Internal Medicine Nara Medical University  Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Yoshiji","sequence":"additional","affiliation":[{"name":"The Third Department of Internal Medicine Nara Medical University  Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuni","family":"Nakanuma","sequence":"additional","affiliation":[{"name":"Department of Human Pathology Kanazawa University Graduate School of Medicine  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Takikawa","sequence":"additional","affiliation":[{"name":"Department of Medicine Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Japan PBC Study Group 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