TABLE 1.
ITCH (from Hep Comm. 2018;2:1184–98) | ALGS LOGIC natural history cohort |
Inclusion criteria | |
Diagnosis of ALGS | LOGIC definition of ALGS |
Age 12 months–18 years inclusive | Age 12 months–18 years inclusive |
Cholestasis | Cholestasis |
Total serum bile acid > 3× ULN for age or | Total serum bile acids > 50 μM or |
Direct bilirubin > 1 mg/dl or | Direct bilirubin or conjugated bilirubin > 1 mg/dl or |
Fat soluble vitamin deficiency or | Not applied or |
GGT > 3× ULN for age or | GGT > 150 IU/L or |
Intractable pruritus based on liver disease | CSS score of 3 or 4 |
Pruritus—average daily ItchRO (observed) ≥ 2.0 | CSS score ≥ 2.0 |
Exclusion criteria | |
Chronic diarrhea requiring intravenous fluids | Not applied |
Surgical interruption of the enterohepatic circulation | From LOGIC history for surgery |
Liver transplant | From LOGIC history for surgery |
ALT > 15× ULN | ALT > 600 insulin resistance/L at baseline |
Decompensated cirrhosis | Decompensated cirrhosis |
INR > 1.5 after vitamin K | Not applied—problem ascertaining vitamin K given |
Albumin < 3.0 gr/dl | Albumin < 3.0 gr/dl |
History of or presence of significant ascites | History of clinically evident ascites |
History of variceal hemorrhage | History of gastrointestinal hemorrhage |
History of encephalopathy | Not applied—not available |
History of other liver disease | Reviewed historical date—excluded participants with prior Kasai hepatoportoenterostomy and diagnosis of biliary atresia |
History of disease that could interfere with absorption of, e.g., drugs and bile acids, from intestine | Not applied—data unavailable but unlikely |
Unable to complete study | Listed for liver transplant |
Concomitant meds—cholestyramine or other resin, sodium phenylbutyrate, investigational agent trial | Applied as known |
Nonadherence concern | Not applied |
Abbreviations: GGT, gamma‐glutamyltransferase; INR, international normalized ratio.