Prognostic value of liver stiffness measurement vs. biochemical response in primary biliary cholangitis

Yu Jun Wong; Laurent Lam; Pierre-Antoine Soret; Sara Lemoinne; Bettina Hansen; Gideon Hirschfield; Aliya Gulamhusein; Ellina Lytvyak; Albert Pares; Ignasi Olivas; Maria-Carlota Londono; Sergio Rogriguez-Tajes; John E. Eaton; Karim T. Osman; Christoph Schramm; Marcial Sebode; Ansgar W. Lohse; George Dalekos; Nikolaos Gatselis; Frederik Nevens; Nora Cazzagon; Alessandra Zago; Francesco Paolo Russo; Annarosa Floreani; Nadir Abbas; Palak Trivedi; Douglas Thorburn; Francesca Saffioti; Laszlo Barkai; Davide Roccarina; Vicenza Calvaruso; Anna Fichera; Adèle Delamarre; Natalia Sobenko; Alejandra Maria Villamil; Esli Medina-Morales; Alan Bonder; Vilas Patwardhan; Cristina Rigamonti; Marco Carbone; Pietro Invernizzi; Laura Cristoferi; Adriaan van der Meer; Rozanne de Veer; Ehud Zigmond; Eyal Yehezkel; Andreas E. Kremer; Ansgar Deibel; Tony Bruns; Karsten Große; Aaron Wetten; Jessica Katharine Dyson; David Jones; Cynthia Levy; Atsushi Tanaka; Jérôme Dumortier; Georges-Philippe Pageaux; Victor de Lédinghen; Fabrice Carrat; Olivier Chazouillères; Christophe Corpechot; Aldo J. Montano-Loza; Global & ERN Rare-Liver PBC Study Groups

doi:10.1016/j.jhep.2025.09.024

Retour

Prognostic value of liver stiffness measurement vs. biochemical response in primary biliary cholangitis

Article de revue

Avec comité de lecture

Prognostic value of liver stiffness measurement vs. biochemical response in primary biliary cholangitis

Yu Jun Wong, Laurent Lam, Pierre-Antoine Soret, Sara Lemoinne, Bettina Hansen, Gideon Hirschfield, Aliya Gulamhusein, Ellina Lytvyak, Albert Pares, Ignasi Olivas, …

Journal of hepatology

03/10/2025

DOI: https://doi.org/10.1016/j.jhep.2025.09.024

PMID: 41047080

Résumé

clinically significant portal hypertension

decompensation

Liver stiffness

non-invasive

portal hypertension

prediction

vibration-controlled elastography

Both liver stiffness measurement (LSM) and biochemical response have prognostic significance in patients with primary biliary cholangitis (PBC). However, the frequency and clinical relevance of discordant biochemical and LSM changes remain unclear. We aim to determine the performance of the most recent or current LSM (LSMc) in predicting first hepatic decompensation (HD) in the setting of discordant biochemical and LSM responses. In this international, multicenter study, we included patients with at least two reliable LSM performed at least 6 months apart. Patients with prior HD, liver transplantation or hepatocellular carcinoma were excluded. Biochemical response was based on the Paris-II criteria. LSM response was defined as stable or any reduction in LSM. The primary outcome was the occurrence of the first HD. Secondary outcomes were liver transplantation and liver-related death. The influence of LSM on HD was estimated using Cox regression analysis. A total of 1,793 patients with PBC were analyzed. Over a median follow-up of 22 (IQR 12-39) months, 3.3% developed HD. Up to 55% of patients with PBC exhibited discordance between LSM and biochemical response. Among patients with LSM response, achieving Paris-II criteria was associated with a lower risk of HD (hazard ratio [HR] 0.25, 95% CI 0.06-0.97, p <0.044). Among patients with biochemical response, LSM response did not influence the risk of developing HD (HR 0.64, 95% CI 0.21-1.96, p = 0.429). The LSMc >10 kPa strongly predicted HD (HR 14.5, 95% CI 6.9-30.6, p <0.001), irrespective of biochemical response and prior LSM trajectories. Discordance between LSM and biochemical response is frequent. Most recent or current LSM is the strongest predictor of first liver-related events in patients with PBC, irrespective of prior biochemical response or LSM trajectory. Both liver stiffness measurement (LSM) and biochemical response have prognostic significance in patients with primary biliary cholangitis. However, the clinical relevance and how discordant biochemical and LSM changes should be best interpreted remain unclear. In this large international multicenter study, we demonstrated that once the current LSM is known, prior LSM trajectories and biochemical changes did not improve the prediction of liver-related events in patients with primary biliary cholangitis. Our finding addresses a common clinical dilemma in risk-stratifying PBC patients with discordant biochemical and LSM responses. Importantly, the use of the latest LSM value for risk prediction significantly simplifies the use of LSM in clinical decision-making for PBC patients with multiple LSM readings. [Display omitted] •Both LSM and biochemical response have prognostic significance in PBC.•Discordance between LSM and biochemical response is frequent in PBC.•Latest LSM >10 kPa strongly predicts liver-related events in PBC, irrespective of prior biochemical response or LSM trajectory.

Indicateurs

1 Consultations de la notice

See more details

Détails

Titre: Prognostic value of liver stiffness measurement vs. biochemical response in primary biliary cholangitis
Créateurs - sans rôle: Yu Jun Wong
Laurent Lam - Inserm
Pierre-Antoine Soret
Sara Lemoinne - Inserm
Bettina Hansen - University of Toronto
Gideon Hirschfield - University of Toronto
Aliya Gulamhusein - University of Toronto
Ellina Lytvyak - University of Alberta
Albert Pares - Liver Unit, Hospital Clínic Barcelona, Institut de Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, European Reference Network on Hepatological Diseases (ERN Rare-Liver), Barcelona, Spain
Ignasi Olivas - Centro de Investigación Biomédica en Red
Maria-Carlota Londono - Liver Unit, Hospital Clínic Barcelona, Institut de Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, European Reference Network on Hepatological Diseases (ERN Rare-Liver), Barcelona, Spain
Sergio Rogriguez-Tajes - Liver Unit, Hospital Clínic Barcelona, Institut de Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, European Reference Network on Hepatological Diseases (ERN Rare-Liver), Barcelona, Spain
John E. Eaton - Mayo Clinic
Karim T. Osman - Mayo Clinic
Christoph Schramm - Department of Medicine I and Martin Zeitz Center for Rare Diseases, European Reference Network on Hepatological Diseases (ERN Rare-Liver), University Medical Center Hamburg–Eppendorf, Hamburg, Germany
Marcial Sebode - Department of Medicine I and Martin Zeitz Center for Rare Diseases, European Reference Network on Hepatological Diseases (ERN Rare-Liver), University Medical Center Hamburg–Eppendorf, Hamburg, Germany
Ansgar W. Lohse - Department of Medicine I and Martin Zeitz Center for Rare Diseases, European Reference Network on Hepatological Diseases (ERN Rare-Liver), University Medical Center Hamburg–Eppendorf, Hamburg, Germany
George Dalekos - Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, European Reference Network on Hepatological Diseases (ERN Rare-Liver), General University Hospital, Larissa, Greece
Nikolaos Gatselis - University Hospital of Larissa
Frederik Nevens - KU Leuven
Nora Cazzagon - Department of Surgery, Oncology and Gastroenterology, European Reference Network on Hepatological Diseases (ERN Rare-Liver), University of Padova, Padova, Italy
Alessandra Zago - Public Health and Cancer Prevention Service, Henri Becquerel Comprehensive Cancer Centre, Rouen, France
Francesco Paolo Russo - Department of Surgery, Oncology and Gastroenterology, European Reference Network on Hepatological Diseases (ERN Rare-Liver), University of Padova, Padova, Italy
Annarosa Floreani - Department of Surgery, Oncology and Gastroenterology, European Reference Network on Hepatological Diseases (ERN Rare-Liver), University of Padova, Padova, Italy
Nadir Abbas - Liver Unit, University Hospitals Birmingham National Health Service Foundation Trust Queen Elizabeth, Birmingham, United Kingdom
Palak Trivedi - University of Birmingham
Douglas Thorburn - University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom
Francesca Saffioti - University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom
Laszlo Barkai - University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom
Davide Roccarina - University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom
Vicenza Calvaruso - Section of Gastroenterology and Hepatology, PROMISE, University of Palermo, Palermo, Italy
Anna Fichera - Section of Gastroenterology and Hepatology, PROMISE, University of Palermo, Palermo, Italy
Adèle Delamarre - Department of Hepatology, University Hospitals of Bordeaux, Pessac, France
Natalia Sobenko - Department of Hepatology & Liver Transplantation, Italian Hospital of Buenos Aires, Argentina
Alejandra Maria Villamil - Department of Hepatology & Liver Transplantation, Italian Hospital of Buenos Aires, Argentina
Esli Medina-Morales - Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, USA
Alan Bonder - Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, USA
Vilas Patwardhan - Beth Israel Deaconess Medical Center
Cristina Rigamonti - Department of Internal Medicine, Università del Piemonte Orientale, Novara, Italy
Marco Carbone - University of Milano-Bicocca
Pietro Invernizzi - Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
Laura Cristoferi - Division of Gastroenterology, Center for Autoimmune Liver Diseases, European Reference Network on Hepatological Diseases (ERN RARE-LIVER), IRCCS Fondazione San Gerardo dei Tintori, Monza, Italy
Adriaan van der Meer - Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
Rozanne de Veer - Erasmus MC
Ehud Zigmond - Tel Aviv Sourasky Medical Center
Eyal Yehezkel - The Research Center for Digestive Tract and Liver Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Andreas E. Kremer - Department of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
Ansgar Deibel - Department of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
Tony Bruns - Department of Medicine III, University Hospital RWTH Aachen, European Reference Network on Hepatological Diseases (ERN Rare-Liver), Aachen, Germany
Karsten Große - Department of Medicine III, University Hospital RWTH Aachen, European Reference Network on Hepatological Diseases (ERN Rare-Liver), Aachen, Germany
Aaron Wetten - Department of Hepatology and Liver Transplantation, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, United Kingdom
Jessica Katharine Dyson - Department of Hepatology and Liver Transplantation, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, United Kingdom
David Jones - Department of Hepatology and Liver Transplantation, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, United Kingdom
Cynthia Levy - Division of Digestive Health and Liver Diseases, Schiff Center for Liver Diseases, Miami University, Miami, Florida, USA
Atsushi Tanaka - Department of Medicine, Teikyo University, Tokyo, Japan
Jérôme Dumortier - Hospices Civils de Lyon
Georges-Philippe Pageaux - Department of Hepatology and Liver Transplantation, University Hospital, Montpellier, France
Victor de Lédinghen - Department of Hepatology, University Hospitals of Bordeaux, Pessac, France
Fabrice Carrat - Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, Inserm, Paris, France
Olivier Chazouillères - Inserm
Christophe Corpechot - Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, Inserm, Paris, France
Aldo J. Montano-Loza
Global & ERN Rare-Liver PBC Study Groups
Détails de publication: Journal of hepatology
Éditeur: Elsevier B.V
Identifiants: 99154049309311
Unité académique: Institut de Génétique Moléculaire de Montpellier - IGMM
Langue: English
Type de ressource: Journal article