【据Journal of Hepatology 2020年4月报道】题:原发性胆汁性胆管炎肝移植术后预防性熊去氧胆酸治疗的长期疗效观察(作者Corpechot C等)原发性胆汁性胆管炎(PBC)肝移植术后复发率高,这会损伤移植物和降低患者的生存。熊去氧胆酸(UDCA)...【据Journal of Hepatology 2020年4月报道】题:原发性胆汁性胆管炎肝移植术后预防性熊去氧胆酸治疗的长期疗效观察(作者Corpechot C等)原发性胆汁性胆管炎(PBC)肝移植术后复发率高,这会损伤移植物和降低患者的生存。熊去氧胆酸(UDCA)是目前治疗PBC的标准药物,来自索邦大学圣安东尼研究中心的Corpechot等研究了预防性UDCA治疗对肝移植术后PBC复发的发生率和长期疗效的影响。展开更多
Background&Aims: We used a multistate modeling approach to assess the effect of ursodeoxycholic acid (UDCA) therapy on the natural course of primary biliary cirrhosis (PBC), which remains controversial. Methods: O...Background&Aims: We used a multistate modeling approach to assess the effect of ursodeoxycholic acid (UDCA) therapy on the natural course of primary biliary cirrhosis (PBC), which remains controversial. Methods: Our population included 2 62 patients with PBC who had received 13-15 mg/kg UDCA daily for a mean of 8 ye ars (range, 1-22 years). Data were analyzed using a multistate Markov model, wi th histologic stage progression,death, and orthotopic liver transplantation (OLT ) as main end points. Survival without OLT was comparedwith that predicted by th e updated Mayo model and with the expected survival in the control population. R esults: Forty-five patients developed cirrhosis, 20 underwent OLT, and 16 died by the censor date. Ten deaths were due to liver disease. The overall survival r ates were 92%at 10 years and 82%at 20 years. Survival rates without OLT were 8 4%and 66%at 10 and 20 years,respectively, which were slightly lower than the s urvival rate of an age-and sex-matched control population (relative risk [RR], 1.4; P =. 1) but better than the spontaneous survival rate as predicted by the u pdated Mayo model (RR,. 5; P <. 01). The survival rate of patients in stage 1 an d 2 was similar to that in the control population (RR,. 8; P =. 5), whereas the probability of death or OLT remained significantly increased in treated patients in late histologic stages (RR, 2.2; P <. 05). Conclusions:Treatment with UDCA a lone normalizes the survival rate of patients with PBC when given at early stage s. However, there is a continued need f- or new therapeutic options in patients with advanced disease.展开更多
文摘【据Journal of Hepatology 2020年4月报道】题:原发性胆汁性胆管炎肝移植术后预防性熊去氧胆酸治疗的长期疗效观察(作者Corpechot C等)原发性胆汁性胆管炎(PBC)肝移植术后复发率高,这会损伤移植物和降低患者的生存。熊去氧胆酸(UDCA)是目前治疗PBC的标准药物,来自索邦大学圣安东尼研究中心的Corpechot等研究了预防性UDCA治疗对肝移植术后PBC复发的发生率和长期疗效的影响。
文摘Background&Aims: We used a multistate modeling approach to assess the effect of ursodeoxycholic acid (UDCA) therapy on the natural course of primary biliary cirrhosis (PBC), which remains controversial. Methods: Our population included 2 62 patients with PBC who had received 13-15 mg/kg UDCA daily for a mean of 8 ye ars (range, 1-22 years). Data were analyzed using a multistate Markov model, wi th histologic stage progression,death, and orthotopic liver transplantation (OLT ) as main end points. Survival without OLT was comparedwith that predicted by th e updated Mayo model and with the expected survival in the control population. R esults: Forty-five patients developed cirrhosis, 20 underwent OLT, and 16 died by the censor date. Ten deaths were due to liver disease. The overall survival r ates were 92%at 10 years and 82%at 20 years. Survival rates without OLT were 8 4%and 66%at 10 and 20 years,respectively, which were slightly lower than the s urvival rate of an age-and sex-matched control population (relative risk [RR], 1.4; P =. 1) but better than the spontaneous survival rate as predicted by the u pdated Mayo model (RR,. 5; P <. 01). The survival rate of patients in stage 1 an d 2 was similar to that in the control population (RR,. 8; P =. 5), whereas the probability of death or OLT remained significantly increased in treated patients in late histologic stages (RR, 2.2; P <. 05). Conclusions:Treatment with UDCA a lone normalizes the survival rate of patients with PBC when given at early stage s. However, there is a continued need f- or new therapeutic options in patients with advanced disease.
