Number needed to treat with ursodeoxycholic acid therapy to prevent liver transplantation or death in primary biliary cholangitis
| العنوان: | Number needed to treat with ursodeoxycholic acid therapy to prevent liver transplantation or death in primary biliary cholangitis |
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| المؤلفون: | Keith D. Lindor, Andrew Mason, B.E. Hansen, Maren H. Harms, Cyriel Y. Ponsioen, Gideon M. Hirschfield, Adriaan J. van der Meer, Christophe Corpechot, Willem J Lammers, Albert Parés, Rozanne C de Veer, Kris V. Kowdley, Douglas Thorburn, Palak J. Trivedi, Pier Maria Battezzati, Marlyn J. Mayo, Pietro Invernizzi, Annarosa Floreani, Harry L. A. Janssen, Henk R. van Buuren, Frederik Nevens |
| المساهمون: | Gastroenterology and Hepatology, AGEM - Digestive immunity, AGEM - Endocrinology, metabolism and nutrition, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Centre de Référence des Maladies Rares - Maladies Inflammatoires des Voies Biliaires et Service d’Hépatologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Royal Free Hospital [London, UK], University College of London [London] (UCL), Toronto Western Hospital, Arizona State University [Tempe] (ASU), Mayo Clinic [Rochester], University of Birmingham [Birmingham], Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBERehd), Liver Unit, Clínica Universitaria, CIBER-EHD, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Universita degli Studi di Padova, University of Texas Southwestern Medical Center, University of Milan, University Hospitals Leuven [Leuven], VU University Medical Center [Amsterdam], University of Alberta, Harms, M, De Veer, R, Lammers, W, Corpechot, C, Thorburn, D, Janssen, H, Lindor, K, Trivedi, P, Hirschfield, G, Pares, A, Floreani, A, Mayo, M, Invernizzi, P, Battezzati, P, Nevens, F, Ponsioen, C, Mason, A, Kowdley, K, Hansen, B, Buuren, H, Van Der Meer, A, Gastroenterology & Hepatology |
| المصدر: | Gut. BMJ Publishing Group Gut Gut, BMJ Publishing Group, 2020, 69 (8), pp.1502-1509. ⟨10.1136/gutjnl-2019-319057⟩ Dipòsit Digital de la UB Universidad de Barcelona Gut, 69(8), 1502-1509. BMJ Publishing Group |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Liver Cirrhosis, Male, Cholagogues and Choleretics, Cirrhosis, Databases, Factual, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Trasplantament hepàtic, Liver transplantation, Gastroenterology, hepatobiliary disease, 0302 clinical medicine, Primary biliary cirrhosis, MED/12 - GASTROENTEROLOGIA, Liver Cirrhosis, Biliary, Hepatobiliary disease, Ursodeoxycholic Acid, Middle Aged, Ursodeoxycholic acid, 3. Good health, Survival Rate, Treatment Outcome, Hepatic cirrhosis, 030220 oncology & carcinogenesis, Number needed to treat, 030211 gastroenterology & hepatology, Female, medicine.drug, Numbers Needed To Treat, Adult, medicine.medical_specialty, Cirrosi hepàtica, clinical decision making, liver, 03 medical and health sciences, Internal medicine, medicine, Mortalitat, Humans, Mortality, Survival rate, Aged, Proportional Hazards Models, business.industry, Proportional hazards model, medicine.disease, Alkaline Phosphatase, Liver Transplantation, primary biliary cirrhosis, Chronic Disease, business, Hepatic transplantation |
| الوصف: | ObjectiveThe clinical benefit of ursodeoxycholic acid (UDCA) in primary biliary cholangitis (PBC) has never been reported in absolute measures. The aim of this study was to assess the number needed to treat (NNT) with UDCA to prevent liver transplantation (LT) or death among patients with PBC.MethodsThe NNT was calculated based on the untreated LT-free survival and HR of UDCA with respect to LT or death as derived from inverse probability of treatment weighting-adjusted Cox proportional hazard analyses within the Global PBC Study Group database.ResultsWe included 3902 patients with a median follow-up of 7.8 (4.1–12.1) years. The overall HR of UDCA was 0.46 (95% CI 0.40 to 0.52) and the 5-year LT-free survival without UDCA was 81% (95% CI 79 to 82). The NNT to prevent one LT or death within 5 years (NNT5y) was 11 (95% CI 9 to 13). Although the HR of UDCA was similar for patients with and without cirrhosis (0.33 vs 0.31), the NNT5y was 4 (95% CI 3 to 5) and 20 (95% CI 14 to 34), respectively. Among patients with low alkaline phosphatase (ALP) (≤2× the upper limit of normal (ULN)), intermediate ALP (2–4× ULN) and high ALP (>4× ULN), the NNT5y to prevent one LT or death was 26 (95% CI 15 to 70), 11 (95% CI 8 to 17) and 5 (95% CI 4 to 8), respectively.ConclusionThe absolute clinical efficacy of UDCA with respect to LT or death varied with baseline prognostic characteristics, but was high throughout. These findings strongly emphasise the incentive to promptly initiate UDCA treatment in all patients with PBC and may improve patient compliance. |
| وصف الملف: | ELETTRONICO; application/pdf; Print-Electronic |
| اللغة: | English |
| تدمد: | 0017-5749 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5382f95a743fc309414925dc11bd1dcd https://doi.org/10.1136/gutjnl-2019-319057 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....5382f95a743fc309414925dc11bd1dcd |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00175749 |
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