Fig. 1.

Multistate model of the transitions between UDCA response states over time.

This figure outlines biochemical response states through which patients progressively transition in the multistate model. Patients enter the model as IR-1 or AR-1 and progress through states sequentially or remain in a state if no change. Patients may transition to liver transplantation or death from any state at any point in time. For example, a patient with inadequate response at 1 year will begin as IR-1. This patient will transition to AR-1 when they achieve adequate response. This patient’s state will change to IR-2 if they transition back to inadequate response and will change to AR-2 if they achieve adequate response once again. The patient’s state will change to IR-3 if they transition back to inadequate response for a third time and will transition to AR-3 if they achieve adequate response for a third time. State changes beyond the fourth instance of inadequate response are absorbed into the IR-4+ state. We applied a composite endpoint of liver transplantation or death and patients without one of these two events were censored at last known date alive. Patients can transition to liver transplantation or death from any state at any point in time. AR-, adequate response; IR-, inadequate response; LT, liver transplantation; UDCA, ursodeoxycholic acid.