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Original Article

Clinical Features and Response to UDCA Treatment of Primary Biliary Cirrhosis

Joo Young Kim, Tae Hun Kim, Kwon Yoo, Ye Ji Han, Jeong Eun Choi, Ji Yoon Kim, Min-Sun Cho1
The Ewha Medical Journal 2015;38(3):106-111. Published online: October 31, 2015

Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

1Department of Pathology, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Tae Hun Kim. Department of Internal Medicine, Ewha Womans University Medical Center, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea. Tel: 82-2-2650-2724, Fax: 82-2-2655-2076, thkm@ewha.ac.kr
• Received: July 8, 2015   • Accepted: September 17, 2015

Copyright © 2015, The Ewha Medical Journal

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease that may progress to end stage liver cirrhosis. Benefits of ursodeoxycholic acid (UDCA) treatment has been investigated through large clinical studies. However, most of the studies were done in western countries and recent increase in prevalence of this relatively uncommon chronic liver disease draws attention in Korea. As early UDCA treatment effectively prevent the grave consequences of PBC progression, early diagnosis and lifelong management with UDCA is important. This study was designed to investigate the clinical features of PBC and response rates of UDCA treatments in Ewha Womans University Medical Center.
  • Methods
    Clinical data of PBC patients diagnosed between 2001 and 2014 at Ewha Womans University Medical Center were analyzed retrospectively.
  • Results
    A total of 35 patients with mean follow-up duration of 42 months were enrolled. At the diagnosis, 72.7% of the patients were asymptomatic, 5.7% had decompensated liver cirrhosis. The mean serum alkaline phosphate (ALP) level was 2.65 times upper limit of normal. UDCA was prescribed in 91.4% of the patients (n=32), among which 77.4% exhibited biochemical responses defined as serum ALP less than 2 upper limit of normal at 6 months (Mayo criteria).
  • Conclusion
    Most PBC patients were asymptomatic at the time of diagnosis and the average biochemical responses rate to UDCA treatment were ranged from 60.0% to 78.9% according to various response criteria. To elucidate the clinical features and courses of Korean PBC patients in detail, larger scale investigations and longer clinical follow up studies are warranted.
  • Keywords: Liver cirrhosis; Biliary; Ursodeoxycholic acid
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Fig. 1

Mean serum ALP, γ-GT, AST, bilirubin levels at baseline and after 6 months, 12 months for UDCA treatment.

emj-38-106-g001.jpg
Fig. 2

Mean serum ALP, γ-GT, AST, bilirubin level according to Mayo Risk Score (MRS) at baseline and 6 months for UDCA treatment.

emj-38-106-g002.jpg
Table 1

Main clinical and biological characteristics of the patients

*MELD score [7], 2001: R=3.8xloge (bilirubin [mg/dL])+11.2xloge (INR) +9.6xloge (creatinine [mg/dL])+6.4x(etiology: 0 if cholestatic or alcoholic, 1 otherwise).

†Mayo score [6], 2000: age (0 point for 38, 1 for 38 to 62 and 2 for 63 years), bilirubin (0 point for 1, 1 for 1 to 1.7, 2 for 1.7 to 6.4, and 3 for 6.4 mg/dL), albumin (0 point for 4.1, 1 for 2.8 to 4.1, and 2 for 2.8 g/dL), prothrombin time (1 point for normal and 2 for prolonged), and edema (0 point for absent and 1 for present).

‡AMA, antimitochondrial antibody.

emj-38-106-i001.jpg
Table 2

Characteristics of the patients according to AMA positivity

Values are presented as mean±SD.

*P<0.05.

emj-38-106-i002.jpg
Table 3

Response rate to UDCA treatment according to various criteria and AMA positivity

ULN, upper limit of normal.

emj-38-106-i003.jpg

Figure & Data

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      Clinical Features and Response to UDCA Treatment of Primary Biliary Cirrhosis
      Ewha Med J. 2015;38(3):106-111.   Published online October 31, 2015
      DOI: https://doi.org/10.12771/emj.2015.38.3.106
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      Clinical Features and Response to UDCA Treatment of Primary Biliary Cirrhosis
      Ewha Med J. 2015;38(3):106-111.   Published online October 31, 2015
      DOI: https://doi.org/10.12771/emj.2015.38.3.106
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      Figure

      • 0
      • 1
      Clinical Features and Response to UDCA Treatment of Primary Biliary Cirrhosis
      Image Image
      Fig. 1 Mean serum ALP, γ-GT, AST, bilirubin levels at baseline and after 6 months, 12 months for UDCA treatment.
      Fig. 2 Mean serum ALP, γ-GT, AST, bilirubin level according to Mayo Risk Score (MRS) at baseline and 6 months for UDCA treatment.

      Fig. 1

      Fig. 2

      Clinical Features and Response to UDCA Treatment of Primary Biliary Cirrhosis

      Main clinical and biological characteristics of the patients

      *MELD score [7], 2001: R=3.8xloge (bilirubin [mg/dL])+11.2xloge (INR) +9.6xloge (creatinine [mg/dL])+6.4x(etiology: 0 if cholestatic or alcoholic, 1 otherwise).

      †Mayo score [6], 2000: age (0 point for 38, 1 for 38 to 62 and 2 for 63 years), bilirubin (0 point for 1, 1 for 1 to 1.7, 2 for 1.7 to 6.4, and 3 for 6.4 mg/dL), albumin (0 point for 4.1, 1 for 2.8 to 4.1, and 2 for 2.8 g/dL), prothrombin time (1 point for normal and 2 for prolonged), and edema (0 point for absent and 1 for present).

      ‡AMA, antimitochondrial antibody.

      Characteristics of the patients according to AMA positivity

      Values are presented as mean±SD.

      *P<0.05.

      Response rate to UDCA treatment according to various criteria and AMA positivity

      ULN, upper limit of normal.
      Table 1 Main clinical and biological characteristics of the patients

      *MELD score [7], 2001: R=3.8xloge (bilirubin [mg/dL])+11.2xloge (INR) +9.6xloge (creatinine [mg/dL])+6.4x(etiology: 0 if cholestatic or alcoholic, 1 otherwise).

      †Mayo score [6], 2000: age (0 point for 38, 1 for 38 to 62 and 2 for 63 years), bilirubin (0 point for 1, 1 for 1 to 1.7, 2 for 1.7 to 6.4, and 3 for 6.4 mg/dL), albumin (0 point for 4.1, 1 for 2.8 to 4.1, and 2 for 2.8 g/dL), prothrombin time (1 point for normal and 2 for prolonged), and edema (0 point for absent and 1 for present).

      ‡AMA, antimitochondrial antibody.

      Table 2 Characteristics of the patients according to AMA positivity

      Values are presented as mean±SD.

      *P<0.05.

      Table 3 Response rate to UDCA treatment according to various criteria and AMA positivity

      ULN, upper limit of normal.

      Table 1

      Table 2

      Table 3

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