Prognostic utility of albumin-bilirubin grade in Japanese patients with primary biliary cholangitis

Yamashita, Yūki; Umemura, Takeji; Kimura, Takefumi; Joshita, Satoru; Hirohara, Junko; Nakano, Toshiaki; Komori, Atsumasa; Tanaka, Atsushi

doi:10.1016/j.jhepr.2022.100662

Cited by 8 publications

(3 citation statements)

References 35 publications

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“…Both the albumin–bilirubin score and the neutrophil-to-lymphocyte ratio predict liver mortality. 38 , 39 The best predictive scoring system for pre-treatment response to UDCA remains the UDCA response score, with an AUROC value >0.8 in the original paper and in the validation publications. 33 , 40 – 42 In addition, the UDCA response score correlates very well with the histological changes according to the Nakanuma classification.…”

Section: Prognostic Aspects Of Pbc In Udca Treatmentmentioning

confidence: 99%

The treatment of primary biliary cholangitis: from shadow to light

Sylvia,

Tomas,

Marian

et al. 2024

Therap Adv Gastroenterol

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Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic disease characterized by the destruction of the small intrahepatic bile ducts, which can progress to liver cirrhosis. The gold standard in the treatment of PBC is ursodeoxycholic acid (UDCA), which is indicated in all patients with PBC because it improves not only biochemical parameters but also patients’ survival. An important milestone in the identification of patients at risk is the assessment of biochemical response to UDCA. Patients who respond to treatment have a lower incidence of hepatic events and better prognosis than patients who do not. Several scoring systems can be used to assess the response and identify non-responders who will benefit from second-line treatment. Obeticholic acid (OCA) is currently the only approved second-line treatment for PBC, which is effective for non-responders to UDCA therapy or patients, who have not tolerated UDCA therapy. However, OCA is contraindicated in advanced liver cirrhosis and portal hypertension. Moreover, pruritus may be a limiting factor for the administration of OCA. Fibrates have shown promising data supporting their use in non-responders to UDCA because they improve the biochemical parameters and elastographic findings and have possible antipruritic effects. Therefore, the idea of a triple treatment seems interesting. Clinical research is focusing on several other groups of drugs: peroxisome proliferator-activated receptor (PPAR) δ- and α/δ agonists, non-steroidal farnesoid X receptor agonists, fibroblast growth factor 19 modulators, and inhibitors of nicotinamide adenine dinucleotide phosphate oxidase 1 and 4.

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Section: Prognostic Aspects Of Pbc In Udca Treatmentmentioning

confidence: 99%

The treatment of primary biliary cholangitis: from shadow to light

Sylvia,

Tomas,

Marian

et al. 2024

Therap Adv Gastroenterol

View full text Add to dashboard Cite

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“…Progressive elevation of serum bilirubin levels and a decline in liver synthetic function are poor prognostic factors for PBC[ 4 ]. The ALBI score not only combines these two factors but is also significantly correlated with histological changes, another poor prognostic factor for PBC[ 5 , 6 ]. In a retrospective study that included 61 patients with primary biliary cirrhosis, Chan et al [ 7 ] compared the prognostic performance of the Child-Pugh, MELD, Mayo risk, Yale, European, Newcastle, and ALBI scores.…”

Section: Albi Score In Primary Biliary Cholangitismentioning

confidence: 99%

“…It has also been identified as the only independent predictor of these prognostic scores as well as histological stage[ 7 ]. Considering the small sample size in this study, a cohort study was performed that included 8768 patients; the authors found that a higher ALBI grade was associated with significantly higher all-cause mortality or the need for liver transplantation (LT), as well as liver-related mortality or the need for LT; the 5-year cumulative LT-free survival rates for patients in the ALBI grades I, II, and III groups were 97.2%, 82.4%, and 38.8%, respectively[ 6 ]. Time-dependent receiver operating characteristic curve (ROC) analysis showed that the ALBI score had higher areas under the ROC (AUROCs) than other markers for predicting overall survival and the incidence of LT[ 8 ].…”

Section: Albi Score In Primary Biliary Cholangitismentioning

confidence: 99%

Role of albumin-bilirubin score in non-malignant liver disease

Xu,

Yang,

et al. 2024

World J Gastroenterol

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The albumin-bilirubin (ALBI) score, which was proposed to assess the prognosis of patients with hepatocellular carcinoma, has gradually been extended to other liver diseases in recent years, including primary biliary cholangitis, liver cirrhosis, hepatitis, liver transplantation, and liver injury. The ALBI score is often compared with classical scores such as the Child-Pugh and model for end-stage liver disease scores or other noninvasive prediction models. It is widely employed because of its immunity to subjective evaluation indicators and ease of obtaining detection indicators. An increasing number of studies have confirmed that it is highly accurate for assessing the prognosis of patients with chronic liver disease; additionally, it has demonstrated good predictive performance for outcomes beyond survival in patients with liver diseases, such as decompensation events. This article presents a review of the application of ALBI scores in various non-malignant liver diseases.

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A low baseline serum myostatin concentration is associated with poor clinical outcome in patients with primary biliary cholangitis

Hayashi,

Abe,

Sugaya

et al. 2024

J of Gastro and Hepatol

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Background and AimPrimary biliary cholangitis (PBC) is an autoimmune‐mediated cholestatic liver disease that can progress to biliary cirrhosis and liver‐related death. The associations between baseline myostatin levels and clinical outcomes in PBC patients are unknown. We aimed to clarify the influence of myostatin levels on the clinical outcomes of PBC patients.MethodsA total of 119 PBC patients were analyzed in this study. Myostatin levels were measured in stored sera before ursodeoxycholic acid treatment, and their associations with the clinical features and prognosis of PBC patients were analyzed. We analyzed the correlation between serum myostatin and chemokines/cytokines.ResultsSerum myostatin was significantly lower in PBC patients (2343 pg/mL) than in healthy controls (4059 pg/mL, P < 0.001). The prevalence of patients with low myostatin levels increased according to the severity of histological fibrosis. The serum myostatin concentration was negatively correlated with the IL‐6 and leucine‐rich α2 glycoprotein levels, but the chemokine concentration was not correlated with the myostatin concentration. Low myostatin in PBC patients was associated with shorter survival without liver‐related complications (hazard ratio [HR], 3.598; 95% confidence interval [CI], 1.27–10.1; P = 0.015) and shorter transplant‐free survival (HR, 3.129; 95% CI, 1.02–9.56; P = 0.045) independent of pretreatment GLOBE score. Patients with both high pretreatment GLOBE scores and low myostatin levels had poor prognoses (log–rank test: P < 0.001).ConclusionsA low serum myostatin concentration at diagnosis was associated with poor clinical outcomes. Assessment of circulating myostatin levels may improve the prediction of outcomes in patients with PBC.

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Prognostic utility of albumin-bilirubin grade in Japanese patients with primary biliary cholangitis

Cited by 8 publications

References 35 publications

The treatment of primary biliary cholangitis: from shadow to light

The treatment of primary biliary cholangitis: from shadow to light

Role of albumin-bilirubin score in non-malignant liver disease

A low baseline serum myostatin concentration is associated with poor clinical outcome in patients with primary biliary cholangitis

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