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Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis

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Efe, C, Taşçilar, K, Henriksson, I, Lytvyak, E, Alalkim, F, Trivedi, H, Eren, F, Eliasson, J, Beretta-Piccoli, BT, Fischer, J, Calişkan, AR, Chayanupatkul, M, Coppo, C, Ytting, H, Purnak, T, Muratori, L, Werner, M, Muratori, P, Rorsman, F, Önnerhag, K, Günşar, F, Nilsson, E, Heurgué-Berlot, A, Güzelbulut, F, Demir, N, Gönen, C, Semela, D, Aladağ, M, Kiyici, M, Schiano, TD, Montano-Loza, AJ, Berg, T, Ozaslan, E, Yoshida, EM, Bonder, A, Marschall, H-U & Wahlin, S 2019, 'Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis' The American journal of gastroenterology, bind 114, nr. 7, s. 1101-1108. https://doi.org/10.14309/ajg.0000000000000290

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Efe C, Taşçilar K, Henriksson I, Lytvyak E, Alalkim F, Trivedi H, Eren F, Eliasson J, Beretta-Piccoli BT, Fischer J, Calişkan AR, Chayanupatkul M, Coppo C, Ytting H, Purnak T, Muratori L, Werner M, Muratori P, Rorsman F, Önnerhag K, Günşar F, Nilsson E, Heurgué-Berlot A, Güzelbulut F, Demir N, Gönen C, Semela D, Aladağ M, Kiyici M, Schiano TD, Montano-Loza AJ, Berg T, Ozaslan E, Yoshida EM, Bonder A, Marschall H-U, Wahlin S. 2019. Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis. The American journal of gastroenterology. 114(7):1101-1108. https://doi.org/10.14309/ajg.0000000000000290

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Efe, Cumali ; Taşçilar, Koray ; Henriksson, Ida ; Lytvyak, Ellina ; Alalkim, Fatema ; Trivedi, Hirsh ; Eren, Fatih ; Eliasson, Johanna ; Beretta-Piccoli, Benedetta Terziroli ; Fischer, Janett ; Calişkan, Ali Riza ; Chayanupatkul, Maneerat ; Coppo, Claudia ; Ytting, Henriette ; Purnak, Tugrul ; Muratori, Luigi ; Werner, Mårten ; Muratori, Paolo ; Rorsman, Fredrik ; Önnerhag, Kristina ; Günşar, Fulya ; Nilsson, Emma ; Heurgué-Berlot, Alexandra ; Güzelbulut, Fatih ; Demir, Nurhan ; Gönen, Can ; Semela, David ; Aladağ, Murat ; Kiyici, Murat ; Schiano, Thomas D ; Montano-Loza, Aldo J ; Berg, Thomas ; Ozaslan, Ersan ; Yoshida, Eric M ; Bonder, Alan ; Marschall, Hanns-Ulrich ; Wahlin, Staffan. / Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis. I: The American journal of gastroenterology. 2019 ; Bind 114, Nr. 7. s. 1101-1108.

Bibtex

@article{3e54c5787cb243ed980a11f312178d5c,
title = "Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis",
abstract = "INTRODUCTION: Risk stratification based on biochemical variables is a useful tool for monitoring ursodeoxycholic acid (UDCA)-treated patients with primary biliary cholangitis (PBC). Several UDCA response criteria and scoring systems have been proposed for risk prediction in PBC, but these have not been validated in large external cohorts.METHODS: We performed a study on data of 1746 UDCA-treated patients with PBC from 25 centers in Europe, United States, and Canada. The prognostic performance of the risk scoring systems (GLOBE and UK-PBC) and the UDCA response criteria (Barcelona, Paris I, Paris II, Rotterdam, and Toronto) were evaluated. We regarded cirrhosis-related complications (ascites, variceal bleeding, and/or hepatic encephalopathy) as clinical end points.RESULTS: A total of 171 patients reached a clinical end point during a median 7 years (range 1-16 years) of follow-up. The 5-, 10- and 15-year adverse outcome-free survivals were 95{\%}, 85{\%}, and 77{\%}. The GLOBE and UK-PBC scores predicted cirrhosis-related complications better than the UDCA response criteria. The hazard ratio (HR) for a 1 standard deviation increase was HR 5.05 (95{\%} confidence interval (CI): 4.43-5.74, P < 0.001) for the GLOBE score and HR 3.39 (95{\%} CI: 3.10-3.72, P < 0.001) for the UK-PBC score. Overall, the GLOBE and UK-PBC risk scores showed similar and excellent prognostic performance (C-statistic, 0.93; 95{\%} CI: 0.91{\%}-95{\%} vs 0.94; 95{\%} CI: 0.91{\%}-0.96{\%}).DISCUSSION: In our international, multicenter PBC cohort, the GLOBE and UK-PBC risk scoring systems were good predictors of future cirrhosis-related complications.",
author = "Cumali Efe and Koray Taş{\cc}ilar and Ida Henriksson and Ellina Lytvyak and Fatema Alalkim and Hirsh Trivedi and Fatih Eren and Johanna Eliasson and Beretta-Piccoli, {Benedetta Terziroli} and Janett Fischer and Calişkan, {Ali Riza} and Maneerat Chayanupatkul and Claudia Coppo and Henriette Ytting and Tugrul Purnak and Luigi Muratori and M{\aa}rten Werner and Paolo Muratori and Fredrik Rorsman and Kristina {\"O}nnerhag and Fulya G{\"u}nşar and Emma Nilsson and Alexandra Heurgu{\'e}-Berlot and Fatih G{\"u}zelbulut and Nurhan Demir and Can G{\"o}nen and David Semela and Murat Aladağ and Murat Kiyici and Schiano, {Thomas D} and Montano-Loza, {Aldo J} and Thomas Berg and Ersan Ozaslan and Yoshida, {Eric M} and Alan Bonder and Hanns-Ulrich Marschall and Staffan Wahlin",
year = "2019",
doi = "10.14309/ajg.0000000000000290",
language = "English",
volume = "114",
pages = "1101--1108",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "7",

}

RIS

TY - JOUR

T1 - Validation of Risk Scoring Systems in Ursodeoxycholic Acid-Treated Patients With Primary Biliary Cholangitis

AU - Efe, Cumali

AU - Taşçilar, Koray

AU - Henriksson, Ida

AU - Lytvyak, Ellina

AU - Alalkim, Fatema

AU - Trivedi, Hirsh

AU - Eren, Fatih

AU - Eliasson, Johanna

AU - Beretta-Piccoli, Benedetta Terziroli

AU - Fischer, Janett

AU - Calişkan, Ali Riza

AU - Chayanupatkul, Maneerat

AU - Coppo, Claudia

AU - Ytting, Henriette

AU - Purnak, Tugrul

AU - Muratori, Luigi

AU - Werner, Mårten

AU - Muratori, Paolo

AU - Rorsman, Fredrik

AU - Önnerhag, Kristina

AU - Günşar, Fulya

AU - Nilsson, Emma

AU - Heurgué-Berlot, Alexandra

AU - Güzelbulut, Fatih

AU - Demir, Nurhan

AU - Gönen, Can

AU - Semela, David

AU - Aladağ, Murat

AU - Kiyici, Murat

AU - Schiano, Thomas D

AU - Montano-Loza, Aldo J

AU - Berg, Thomas

AU - Ozaslan, Ersan

AU - Yoshida, Eric M

AU - Bonder, Alan

AU - Marschall, Hanns-Ulrich

AU - Wahlin, Staffan

PY - 2019

Y1 - 2019

N2 - INTRODUCTION: Risk stratification based on biochemical variables is a useful tool for monitoring ursodeoxycholic acid (UDCA)-treated patients with primary biliary cholangitis (PBC). Several UDCA response criteria and scoring systems have been proposed for risk prediction in PBC, but these have not been validated in large external cohorts.METHODS: We performed a study on data of 1746 UDCA-treated patients with PBC from 25 centers in Europe, United States, and Canada. The prognostic performance of the risk scoring systems (GLOBE and UK-PBC) and the UDCA response criteria (Barcelona, Paris I, Paris II, Rotterdam, and Toronto) were evaluated. We regarded cirrhosis-related complications (ascites, variceal bleeding, and/or hepatic encephalopathy) as clinical end points.RESULTS: A total of 171 patients reached a clinical end point during a median 7 years (range 1-16 years) of follow-up. The 5-, 10- and 15-year adverse outcome-free survivals were 95%, 85%, and 77%. The GLOBE and UK-PBC scores predicted cirrhosis-related complications better than the UDCA response criteria. The hazard ratio (HR) for a 1 standard deviation increase was HR 5.05 (95% confidence interval (CI): 4.43-5.74, P < 0.001) for the GLOBE score and HR 3.39 (95% CI: 3.10-3.72, P < 0.001) for the UK-PBC score. Overall, the GLOBE and UK-PBC risk scores showed similar and excellent prognostic performance (C-statistic, 0.93; 95% CI: 0.91%-95% vs 0.94; 95% CI: 0.91%-0.96%).DISCUSSION: In our international, multicenter PBC cohort, the GLOBE and UK-PBC risk scoring systems were good predictors of future cirrhosis-related complications.

AB - INTRODUCTION: Risk stratification based on biochemical variables is a useful tool for monitoring ursodeoxycholic acid (UDCA)-treated patients with primary biliary cholangitis (PBC). Several UDCA response criteria and scoring systems have been proposed for risk prediction in PBC, but these have not been validated in large external cohorts.METHODS: We performed a study on data of 1746 UDCA-treated patients with PBC from 25 centers in Europe, United States, and Canada. The prognostic performance of the risk scoring systems (GLOBE and UK-PBC) and the UDCA response criteria (Barcelona, Paris I, Paris II, Rotterdam, and Toronto) were evaluated. We regarded cirrhosis-related complications (ascites, variceal bleeding, and/or hepatic encephalopathy) as clinical end points.RESULTS: A total of 171 patients reached a clinical end point during a median 7 years (range 1-16 years) of follow-up. The 5-, 10- and 15-year adverse outcome-free survivals were 95%, 85%, and 77%. The GLOBE and UK-PBC scores predicted cirrhosis-related complications better than the UDCA response criteria. The hazard ratio (HR) for a 1 standard deviation increase was HR 5.05 (95% confidence interval (CI): 4.43-5.74, P < 0.001) for the GLOBE score and HR 3.39 (95% CI: 3.10-3.72, P < 0.001) for the UK-PBC score. Overall, the GLOBE and UK-PBC risk scores showed similar and excellent prognostic performance (C-statistic, 0.93; 95% CI: 0.91%-95% vs 0.94; 95% CI: 0.91%-0.96%).DISCUSSION: In our international, multicenter PBC cohort, the GLOBE and UK-PBC risk scoring systems were good predictors of future cirrhosis-related complications.

U2 - 10.14309/ajg.0000000000000290

DO - 10.14309/ajg.0000000000000290

M3 - Journal article

VL - 114

SP - 1101

EP - 1108

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 7

ER -

ID: 59305699