title: Autoantibody status and histological variables influence biochemical response to treatment and long-term outcomes in Japanese patients with primary biliary cirrhosis.
abstract: OBJECTIVE
  The aim of the present study is to evaluate the factors influencing biochemical response to treatment and the value of biochemical response for predicting long-term outcomes in Japanese patients with primary biliary cirrhosis (PBC).
  
  
  METHODS
  Biochemical response to ursodeoxycholic acid (UDCA) or UDCA plus bezafibrate was defined as good (≤upper limit of normal [ULN]), fair (≤1.5 × ULN) or poor (>1.5 × ULN) at 2 years after initiation of UDCA treatment. Associations between various factors (including age, sex, autoantibody status and histological variables at baseline), biochemical response to treatment and long-term outcomes were evaluated in 164 Japanese PBC patients.
  
  
  RESULTS
  Anti-gp210 positivity and a higher bile duct loss score were significant risk factors for worse alkaline phosphatase (ALP) response (odds ratios [OR], 2.78 and 1.85, respectively). Age, anti-gp210 positivity and anticentromere positivity were significant risk factors for worse alanine aminotransferase (ALT) response (OR, 1.05, 4.0 and 2.77, respectively). Anti-gp210 positivity and a higher hepatitis score were significant risk factors for worse immunoglobulin (Ig)M response (OR, 2.10 and 2.06, respectively). Worse ALP and IgM response were significant risk factors for progression to late-stage disease without jaundice (OR, 2.27 and 2.32, respectively). Worse ALT response was a significant risk factor for progression to late-stage disease with persistent jaundice (OR, 11.11).
  
  
  CONCLUSIONS
  Biochemical response to treatment at 2 years, which is influenced by autoantibody status and histological variables at baseline, can predict long-term outcomes in Japanese patients with PBC.
authors.affiliation: Clinical Research Center in National Hospital Organization (NHO) Nagasaki Medical Center and Department of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Omura, Japan.|Headquaters of gp210 working in Intractable Hepatobiliary Disease Study Group supported by the Ministry of Health, Labor and Welfare of Japan, Tokyo, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kondo
authors.affiliation: Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Clinical Research Center in National Hospital Organization (NHO) Nagasaki Medical Center and Department of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Omura, Japan.
authors.forename: Atsumasa
authors.initials: A
authors.lastname: Komori
authors.affiliation: Clinical Research Center in National Hospital Organization (NHO) Nagasaki Medical Center and Department of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Omura, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
authors.affiliation: Division of Gastroenterology and Hepatology, Tokyo Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Zeniya
authors.affiliation: Department of Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Hashimoto
authors.affiliation: Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Honda
authors.affiliation: Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ueno
authors.affiliation: Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Shimoda
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Arai
authors.affiliation: Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyake
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Taniai
authors.affiliation: Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, Japan.
authors.forename: Toshiji
authors.initials: T
authors.lastname: Saibara
authors.affiliation: Department of Gastroenterology and Medicine, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Sakisaka
authors.affiliation: Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Takikawa
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan.
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
authors.affiliation: Department of Digestive and Lifestyle-related Disease, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Tsubouchi
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.affiliation: Clinical Research Center in National Hospital Organization (NHO) Nagasaki Medical Center and Department of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Omura, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ishibashi
keywords: anti-gp210 antibody; anticentromere antibody; bezafibrate; biochemical response to treatment; histological staging and grading for primary biliary cirrhosis; ursodeoxycholic acid