Paris II and Rotterdam criteria are the best predictors of outcomes in patients with primary biliary cholangitis in Japan

Hepatol Int. 2021 Apr;15(2):437-443. doi: 10.1007/s12072-021-10163-0. Epub 2021 Apr 16.

Abstract

Background: Biochemical response to treatment in patients with primary biliary cholangitis (PBC) reflects prognosis. However, the best predictive criteria to detect biochemical response remain undetermined. In addition, because these criteria need > 6 months until definition, parameters that can estimate its results before initiating treatment are needed.

Methods: We conducted a single-center retrospective study on 196 patients with PBC, followed up for at least 12 months after initiating treatment.

Results: Kaplan-Meier analysis showed that Paris II (p = 0.002) and Rotterdam criteria (p = 0.001) could estimate the overall survival of PBC patients, whereas Paris II (p = 0.001), Rotterdam (p = 0.001), and Rochester criteria (p= 0.025) could estimate liver-related deaths. Cox hazard analysis revealed Paris II and Rotterdam criteria as significantly independent predictors of overall survival (hazard ratio (HR) 3.948, 95% CI 1.293-12.054, p = 0.016 and HR 6.040, 95% CI 1.969-18.527, p = 0.002, respectively) and liver-related deaths (HR 10.461, 95% CI 1.231-88.936, p = 0.032 and HR 10.824, 95% CI 1.252-93.572, p = 0.032, respectively). The results of Paris II criteria could be estimated by serum prothrombin time (Odds ratio (OR) 1.052, 95% CI 1.008-1.098, p = 0.021) and alanine transaminase level (OR 0.954, 95% CI 0.919-0.991, p = 0.014) whereas, those of Rotterdam criteria could be estimated by serum albumin level (OR 3.649, 95% CI 1.098-12.128, p = 0.035) at the time of diagnosis.

Conclusions: This study highlights the best prediction criteria and pre-treatment parameters that facilitate the prognosis of PBC patients.

Keywords: Biochemical response; Cox proportional hazard analysis; Kaplan–Meier analysis; Liver-related deaths; Overall survival; Predictive criteria; Prognosis; Retrospective; Rochester criteria; Ursodeoxycholic acid.

MeSH terms

  • Cholagogues and Choleretics / therapeutic use
  • Humans
  • Japan / epidemiology
  • Liver Cirrhosis, Biliary* / diagnosis
  • Retrospective Studies
  • Treatment Outcome
  • Ursodeoxycholic Acid / therapeutic use

Substances

  • Cholagogues and Choleretics
  • Ursodeoxycholic Acid