BARCELONA — Adding liver stiffness measurement through Fibroscan to Globe and UK-PBC risk scores — two high-performance scoring systems — improved risk stratification for primary biliary cholangitis, according to data presented at International Liver Congress.
“These results suggest Fibroscan may be added to the algorithm for second-line therapy decision in [primary biliary cholangitis], which is a main issue with this disease,” Olivier Chazouillères, MD, of the Service d'Hépatologie, Centre de référence des Maladies Inflammatoires des Voies Biliaires, Hôpital Saint-Antoine in France, said during his presentation.
In this retrospective study, researchers evaluated 200 patients with primary biliary cholangitis (PBC) from a single referral center with at least one valid liver stiffness measurement and a subsequent follow-up of at least 6 months. Liver stiffness measurement was obtained using Fibroscan (Echosens) and The Globe score, UK-PBC risk score, and biochemical response to ursodeoxycholic acid (UDCA, Paris-I score) were also determined at this time.
The primary endpoint was mortality, liver transplantation or occurrence of complications of cirrhosis. Overall, 12.5% of patients met the primary endpoint (n = 15).
Harrel's C index for liver stiffness measurement and Globe score were 0.9, UK-PBC score was 0.86 and Paris-I response was 0.82; these were all associated with outcomes in univariate models.
Liver stiffness measurement provided an additive independent prognostic value to all scoring systems, according to the presentation.
The Liver Stiffness Measurement-Globe score showed a higher predictive performance compared with Globe score alone. This was due to a better concordance for non-event patients (P = .008), according to the presentation. The optimal predictive cutoff for this score was associated with a 124-fold increased risk for events (95% CI, 28.4–542).
“Fibroscan improves performance of biochemical response to UDCA and the new prognostic scores to predict outcomes of PBC,” Chazouillères said. – by Melinda Stevens
Corpechot C, et al. Abstract PS086. Presented at: International Liver Congress; April 13-17, 2016; Barcelona.
Disclosure: The researchers report no relevant financial disclosures.