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Treatment May Be Helpful at Various Stages of Cirrhosis

Study examined responses to ursodeoxycholic acid in patients with primary biliary cirrhosis

WEDNESDAY, April 8 (HealthDay News) -- Patients with primary biliary cirrhosis may have a better long-term outlook if ursodeoxycholic acid (UDCA) treatment normalizes their abnormal bilirubin or albumin concentrations, according to research published in the April issue of Gastroenterology.

Edith M.M. Kuiper, of the Erasmus University Medical Center in Rotterdam, the Netherlands, and colleagues analyzed data from 375 patients with primary biliary cirrhosis who were followed for a median 9.7 years.

Those who responded to the treatment according to criteria proposed by Corpechot (based on alkaline phosphatase, aspartate aminotransferase, and bilirubin levels) and the Rotterdam group (based on normalization of abnormal bilirubin and/or albumin levels) had better survival than non-responders. The prognosis in early disease was similar for responders and non-responders, but in those with moderately advanced disease, responders had a better prognosis, the investigators found.

"In conclusion, the prognosis for the majority of patients with primary biliary cirrhosis (i.e., those presenting with early disease) is excellent and comparable with that of the general population when treatment with UDCA is instituted," the authors write. "Our study suggests that prognosis based on albumin and bilirubin levels is more accurate than prognosis based on changes in alkaline phosphatase level. Normalization of abnormal albumin and bilirubin concentrations following UDCA treatment is associated with improved prognosis. Therefore, our data are compatible with a therapeutic effect of UDCA in primary biliary cirrhosis, irrespective of the stage of the disease."

Two co-authors received a research grant from Zambon Nederland.

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