Table 1.
Criteria for Predicting Outcomes in Primary Biliary Cholangitis Patients: Biochemical Response to UDCA and Risk Stratification
Biochemical Response to Treatment | |||
---|---|---|---|
Qualitative Definition | Number of Patients | Time to Assessment | Responder Criteria |
Rochester-I32 | 180 | 6 months | ALP ≤2-fold ULN |
Barcelona*33 | 192 | 1 year | ALP decreases greater than 40% of baseline values or normal levels after 1 year of treatment. |
Paris-I*6 | 291 | 1 year | Bilirubin level ≤1.0 mg/dL ALP ≤3-fold ULN AST ≤2-fold ULN |
Rotterdam34 | 375 | 1 year | Normalization of bilirubin and/or albumin levels |
Toronto*35 | 69 | 2 years | ALP ≤1.67-fold ULN |
Ehime36 | 83 | 6 months | Normal GGT levels or ≥70% decrease in pre-treatment levels |
Paris-II37 | 165 | 1 year | ALP and AST ≤1.5-fold ULN with a normal bilirubin level |
Rochester-II4 | 73 | 1 year | ALP ≤1.67-fold ULN and bilirubin ≤1 mg/dL |
Global PBC38 | 4845 | 1 year | ALP ≤2-fold ULN and bilirubin ≤1-fold ULN |
Risk Stratification Scores | |||
Quantitative scores | Number of patients | Time to assessment | Included parameters |
APRI-r1 (± biochemical response)39 | 386 | 1 year | Aspartate aminotransferase (AST) and platelet count at 1 year of treatment APRI ≤0.54 ±biochemical response (defined by Barcelona, Paris I/II, or Toronto criteria) |
GLOBE score40 | 4119 | 1 year | Age at start of UDCA ALP, bilirubin, albumin, and platelet count at 12 months |
UK-PBC score41 | 3165 | 1 year | Baseline albumin and platelet count ALP, bilirubin, and AST (or ALT) at 12 months of treatment. |
ALBI, albumin-bilirubin; ALP, alkaline phosphatase; ALT, alanine aminotransferase; APRI-r1, AST/platelet ratio index at 1 year of treatment; AST, aspartate aminotransferase; GGT, gamma-glutamyl transferase; PBC, primary biliary cholangitis; ULN, upper limit of normal.
*Considered the best predictability of transplant-free survival as validated in large studies.