Normal serum bilirubin concentrations in patients with primary biliary cholangitis (PBC) were associated with improved odds of transplant-free survival, according to a study presented at the annual meeting of the American Association for the Study of Liver Diseases.
In a retrospective analysis of data from the Global PBC Study group, PBC patients who had bilirubin levels between normal and the upper limit of normal at baseline (n = 2,795), at 1 year (n = 3,082), at 3 years (n = 1,657), or at 5 years (n = 1,339) were included in the study. Both ursodeoxycholic acid–treated and untreated patients were included, according to Carla Murillo Perez of Toronto General Hospital and her associates.
Each cohort was organized into quartiles, with Q1 having the lowest bilirubin levels and Q4 having the highest. In the baseline cohort, 5-year transplant-free survival rates were 97% in Q1, 95% in Q2, 96% in Q3, and 91% in Q4; similarly improved odds for transplant-free survival in lower quartiles were seen in the later cohorts.
Higher bilirubin (per 0.1 Ă— upper limit of normal increase) was associated with an increased chance for death or transplantation, with hazard ratios of 1.14 in the baseline cohort, 1.21 in the 1-year cohort, 1.19 in the 3-year cohort, and 1.17 in the 5-year cohort, Ms. Perez and her associates said.
Dr. Cyriel Ponsioen, Dr. Christophe Corpechot, Dr. Marlyn Mayo, Dr. Annarosa Floreani, Dr. Albert Pares, Dr. Frederik Nevens, Dr. Kris Kowdley, Dr. Tony Bruns, Dr. Gideon Hirschfield, Dr. Keith Lindor, and Dr. Harry Janssen reported conflicts of interest.