Abstract

The UK-PBC Study group validated a long-term prognostic model of primary biliary cholangitis (PBC) that identified independent predictors of end-stage liver disease (ESLD). POISE was a randomized, double-blind (DB), placebo-controlled 12-month Phase 3 trial investigating obeticholic acid (OCA) treatment of PBC; a 5-year open-label extension (OLE) followed. We assessed the change in predicted risk of ESLD with the UK-PBC model in placebo patients (DB phase) who transitioned to OCA (OLE). POISE inclusion criteria: PBC diagnosis, alkaline phosphatase ≥1.67x upper limit of normal (ULN) and/or total bilirubin >ULN to The median age at baseline in the placebo group was 55 years; 93% were female, and 93% received daily UDCA (median dose, 15 mg/kg). After 1 year of standard-of-care (SOC), placebo patients demonstrated a slight increase in predicted risk of ESLD (table 1). After 1 year of OCA, predicted risk of ESLD at 5, 10, and 15 years was reduced to below baseline levels; these were sustained through the 60-month OLE. In POISE, the UK-PBC risk score predicted an increased risk of ESLD in PBC patients treated with SOC and placebo for 12 months. OCA treatment led to sustained reductions in predicted risk of ESLD through 60 months.

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