Sex, Age at Presentation Affect Cirrhosis Response to Therapy
Men, older patients with primary biliary disease fare better with ursodeoxycholic acid treatment
FRIDAY, March 29 (HealthDay News) -- Among patients with primary biliary cirrhosis (PBC), sex and age at presentation affect the response to ursodeoxycholic acid (UDCA), according to a study published in the March issue of Gastroenterology.
Marco Carbone, from University of Cambridge in the United Kingdom, and colleagues analyzed data from 2,353 patients participating in the United Kingdom-PBC study. Data included diagnosis reports, response to therapy with UDCA, laboratory results, and symptom impact (assessed using the PBC-40 and other related measures).
The researchers found that 79 percent of the patients reported current UDCA therapy, with 80 percent of them meeting Paris response criteria. UDCA response was significantly lower in men than women (72 versus 80 percent). Male sex remained an independent predictor of non-response on multivariate analysis. UDCA response was also strongly and independently associated with age at diagnosis, with response rates ranging from 90 percent among patients who presented with PBC when they were older than age 70 to less than 50 percent for those younger than age 30. Younger patients at presentation also were significantly more likely not to respond to UDCA therapy, based on alanine aminotransferase and aspartate aminotransferase response criteria, but were more likely to report fatigue and pruritus. Women had significantly higher mean fatigue scores than men (32 percent higher) that were related strongly to higher levels of autonomic symptoms.
"Among patients with PBC, response to UDCA, treatment, and symptoms are related to sex and age at presentation, with the lowest response rates and highest levels of symptoms in women presenting at younger than age 50," the authors write.