Natural History of Primary Biliary Cholangitis in the Ursodeoxycholic Acid Era: Role of Scoring Systems

Clin Liver Dis. 2018 Aug;22(3):563-578. doi: 10.1016/j.cld.2018.03.007.

Abstract

Primary biliary cholangitis (PBC) is a chronic disease that progresses to end-stage liver disease. Ursodeoxycholic acid (UDCA), the standard treatment for PBC for several decades, is associated with improved survival without liver transplantation. Approximately 40% of patients do not respond to UDCA. Because of disease variability, several prognostic models exist that incorporate various factors including biochemical response to UDCA. Useful for patient care and counseling as well as risk stratification for research and clinical trials, the role of these models in the pre-UDCA and UDCA eras is discussed.

Keywords: PBC; Predictive models; Prognosis; Scoring systems; Ursodeoxycholic acid.

Publication types

  • Review

MeSH terms

  • Bilirubin / blood
  • Blood Coagulation Disorders / blood
  • Blood Coagulation Disorders / etiology
  • Cholagogues and Choleretics / therapeutic use*
  • Disease Progression
  • End Stage Liver Disease / etiology
  • Humans
  • Liver Cirrhosis, Biliary / blood
  • Liver Cirrhosis, Biliary / complications
  • Liver Cirrhosis, Biliary / therapy*
  • Liver Transplantation*
  • Models, Statistical
  • Prognosis
  • Serum Albumin / metabolism
  • Time Factors
  • Treatment Outcome
  • Ursodeoxycholic Acid / therapeutic use*

Substances

  • Cholagogues and Choleretics
  • Serum Albumin
  • Ursodeoxycholic Acid
  • Bilirubin