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Long-term impact of preventive UDCA therapy after transplantation for primary biliary cholangitis

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Long-term impact of preventive UDCA therapy after transplantation for primary biliary cholangitis. / Corpechot, Christophe; Chazouillères, Olivier; Belnou, Pierre; Montano-Loza, Aldo J; Mason, Andrew; Ebadi, Maryam; Eurich, Dennis; Chopra, Sascha; Jacob, Dietmar; Schramm, Christoph; Sterneck, Martina; Bruns, Tony; Reuken, Philipp; Rauchfuss, Falk; Roccarina, Davide; Thorburn, Douglas; Gerussi, Alessio; Trivedi, Palak; Hirschfield, Gideon; McDowell, Patrick; Nevens, Frederik; Boillot, Olivier; Bosch, Alexie; Giostra, Emiliano; Conti, Filomena; Poupon, Raoul; Parés, Albert; Reig, Anna; Donato, Maria Francesca; Malinverno, Federica; Floreani, Annarosa; Russo, Francesco Paolo; Cazzagon, Nora; Verhelst, Xavier; Goet, Jorn; Harms, Maren; van Buuren, Henk; Hansen, Bettina; Carrat, Fabrice; Dumortier, Jérôme; Global PBC Study Group.

in: J HEPATOL, Jahrgang 73, Nr. 3, 09.2020, S. 559-565.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Corpechot, C, Chazouillères, O, Belnou, P, Montano-Loza, AJ, Mason, A, Ebadi, M, Eurich, D, Chopra, S, Jacob, D, Schramm, C, Sterneck, M, Bruns, T, Reuken, P, Rauchfuss, F, Roccarina, D, Thorburn, D, Gerussi, A, Trivedi, P, Hirschfield, G, McDowell, P, Nevens, F, Boillot, O, Bosch, A, Giostra, E, Conti, F, Poupon, R, Parés, A, Reig, A, Donato, MF, Malinverno, F, Floreani, A, Russo, FP, Cazzagon, N, Verhelst, X, Goet, J, Harms, M, van Buuren, H, Hansen, B, Carrat, F, Dumortier, J & Global PBC Study Group 2020, 'Long-term impact of preventive UDCA therapy after transplantation for primary biliary cholangitis', J HEPATOL, Jg. 73, Nr. 3, S. 559-565. https://doi.org/10.1016/j.jhep.2020.03.043

APA

Corpechot, C., Chazouillères, O., Belnou, P., Montano-Loza, A. J., Mason, A., Ebadi, M., Eurich, D., Chopra, S., Jacob, D., Schramm, C., Sterneck, M., Bruns, T., Reuken, P., Rauchfuss, F., Roccarina, D., Thorburn, D., Gerussi, A., Trivedi, P., Hirschfield, G., ... Global PBC Study Group (2020). Long-term impact of preventive UDCA therapy after transplantation for primary biliary cholangitis. J HEPATOL, 73(3), 559-565. https://doi.org/10.1016/j.jhep.2020.03.043

Vancouver

Corpechot C, Chazouillères O, Belnou P, Montano-Loza AJ, Mason A, Ebadi M et al. Long-term impact of preventive UDCA therapy after transplantation for primary biliary cholangitis. J HEPATOL. 2020 Sep;73(3):559-565. https://doi.org/10.1016/j.jhep.2020.03.043

Bibtex

@article{4b8b0b52e16a4b07ac2ac397c577dd49,
title = "Long-term impact of preventive UDCA therapy after transplantation for primary biliary cholangitis",
abstract = "BACKGROUND & AIMS: Recurrence of primary biliary cholangitis (PBC) after liver transplantation (LT) is frequent and can impair graft and patient survival. Ursodeoxycholic acid (UDCA) is the current standard therapy for PBC. We investigated the effect of preventive exposure to UDCA on the incidence and long-term consequences of PBC recurrence after LT.METHODS: We performed a retrospective cohort study in 780 patients transplanted for PBC, between 1983-2017 in 16 centers (9 countries), and followed-up for a median of 11 years. Among them, 190 received preventive UDCA (10-15 mg/kg/day). The primary outcome was histological evidence of PBC recurrence. The secondary outcomes were graft loss, liver-related death, and all-cause death. The association between preventive UDCA and outcomes was quantified using multivariable-adjusted Cox and restricted mean survival time (RMST) models.RESULTS: While recurrence of PBC significantly shortened graft and patient survival, preventive exposure to UDCA was associated with reduced risk of PBC recurrence (adjusted hazard ratio [aHR] 0.41; 95% CI 0.28-0.61; p <0.0001), graft loss (aHR 0.33; 95% CI 0.13-0.82; p <0.05), liver-related death (aHR 0.46; 95% CI 0.22-0.98; p <0.05), and all-cause death (aHR 0.69; 95% CI 0.49-0.96; p <0.05). On RMST analysis, preventive UDCA led to a survival gain of 2.26 years (95% CI 1.28-3.25) over a period of 20 years. Exposure to cyclosporine rather than tacrolimus had a complementary protective effect alongside preventive UDCA, reducing the cumulative incidence of PBC recurrence and all-cause death.CONCLUSIONS: Preventive UDCA after LT for PBC is associated with a reduced risk of disease recurrence, graft loss, and death. A regimen combining cyclosporine and preventive UDCA is associated with the lowest risk of PBC recurrence and mortality.LAY SUMMARY: Recurrence of primary biliary cholangitis after liver transplantation is frequent and can impair graft and patient survival. We performed the largest international study of transplanted patients with primary biliary cholangitis to date. Preventive administration of ursodeoxycholic acid after liver transplantation was associated with reduced risk of disease recurrence, graft loss, liver-related and all-cause mortality. A regimen combining cyclosporine and preventive ursodeoxycholic acid was associated with the best outcomes.",
author = "Christophe Corpechot and Olivier Chazouill{\`e}res and Pierre Belnou and Montano-Loza, {Aldo J} and Andrew Mason and Maryam Ebadi and Dennis Eurich and Sascha Chopra and Dietmar Jacob and Christoph Schramm and Martina Sterneck and Tony Bruns and Philipp Reuken and Falk Rauchfuss and Davide Roccarina and Douglas Thorburn and Alessio Gerussi and Palak Trivedi and Gideon Hirschfield and Patrick McDowell and Frederik Nevens and Olivier Boillot and Alexie Bosch and Emiliano Giostra and Filomena Conti and Raoul Poupon and Albert Par{\'e}s and Anna Reig and Donato, {Maria Francesca} and Federica Malinverno and Annarosa Floreani and Russo, {Francesco Paolo} and Nora Cazzagon and Xavier Verhelst and Jorn Goet and Maren Harms and {van Buuren}, Henk and Bettina Hansen and Fabrice Carrat and J{\'e}r{\^o}me Dumortier and {Global PBC Study Group}",
note = "Copyright {\textcopyright} 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.",
year = "2020",
month = sep,
doi = "10.1016/j.jhep.2020.03.043",
language = "English",
volume = "73",
pages = "559--565",
journal = "J HEPATOL",
issn = "0168-8278",
publisher = "Elsevier",
number = "3",

}

RIS

TY - JOUR

T1 - Long-term impact of preventive UDCA therapy after transplantation for primary biliary cholangitis

AU - Corpechot, Christophe

AU - Chazouillères, Olivier

AU - Belnou, Pierre

AU - Montano-Loza, Aldo J

AU - Mason, Andrew

AU - Ebadi, Maryam

AU - Eurich, Dennis

AU - Chopra, Sascha

AU - Jacob, Dietmar

AU - Schramm, Christoph

AU - Sterneck, Martina

AU - Bruns, Tony

AU - Reuken, Philipp

AU - Rauchfuss, Falk

AU - Roccarina, Davide

AU - Thorburn, Douglas

AU - Gerussi, Alessio

AU - Trivedi, Palak

AU - Hirschfield, Gideon

AU - McDowell, Patrick

AU - Nevens, Frederik

AU - Boillot, Olivier

AU - Bosch, Alexie

AU - Giostra, Emiliano

AU - Conti, Filomena

AU - Poupon, Raoul

AU - Parés, Albert

AU - Reig, Anna

AU - Donato, Maria Francesca

AU - Malinverno, Federica

AU - Floreani, Annarosa

AU - Russo, Francesco Paolo

AU - Cazzagon, Nora

AU - Verhelst, Xavier

AU - Goet, Jorn

AU - Harms, Maren

AU - van Buuren, Henk

AU - Hansen, Bettina

AU - Carrat, Fabrice

AU - Dumortier, Jérôme

AU - Global PBC Study Group

N1 - Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

PY - 2020/9

Y1 - 2020/9

N2 - BACKGROUND & AIMS: Recurrence of primary biliary cholangitis (PBC) after liver transplantation (LT) is frequent and can impair graft and patient survival. Ursodeoxycholic acid (UDCA) is the current standard therapy for PBC. We investigated the effect of preventive exposure to UDCA on the incidence and long-term consequences of PBC recurrence after LT.METHODS: We performed a retrospective cohort study in 780 patients transplanted for PBC, between 1983-2017 in 16 centers (9 countries), and followed-up for a median of 11 years. Among them, 190 received preventive UDCA (10-15 mg/kg/day). The primary outcome was histological evidence of PBC recurrence. The secondary outcomes were graft loss, liver-related death, and all-cause death. The association between preventive UDCA and outcomes was quantified using multivariable-adjusted Cox and restricted mean survival time (RMST) models.RESULTS: While recurrence of PBC significantly shortened graft and patient survival, preventive exposure to UDCA was associated with reduced risk of PBC recurrence (adjusted hazard ratio [aHR] 0.41; 95% CI 0.28-0.61; p <0.0001), graft loss (aHR 0.33; 95% CI 0.13-0.82; p <0.05), liver-related death (aHR 0.46; 95% CI 0.22-0.98; p <0.05), and all-cause death (aHR 0.69; 95% CI 0.49-0.96; p <0.05). On RMST analysis, preventive UDCA led to a survival gain of 2.26 years (95% CI 1.28-3.25) over a period of 20 years. Exposure to cyclosporine rather than tacrolimus had a complementary protective effect alongside preventive UDCA, reducing the cumulative incidence of PBC recurrence and all-cause death.CONCLUSIONS: Preventive UDCA after LT for PBC is associated with a reduced risk of disease recurrence, graft loss, and death. A regimen combining cyclosporine and preventive UDCA is associated with the lowest risk of PBC recurrence and mortality.LAY SUMMARY: Recurrence of primary biliary cholangitis after liver transplantation is frequent and can impair graft and patient survival. We performed the largest international study of transplanted patients with primary biliary cholangitis to date. Preventive administration of ursodeoxycholic acid after liver transplantation was associated with reduced risk of disease recurrence, graft loss, liver-related and all-cause mortality. A regimen combining cyclosporine and preventive ursodeoxycholic acid was associated with the best outcomes.

AB - BACKGROUND & AIMS: Recurrence of primary biliary cholangitis (PBC) after liver transplantation (LT) is frequent and can impair graft and patient survival. Ursodeoxycholic acid (UDCA) is the current standard therapy for PBC. We investigated the effect of preventive exposure to UDCA on the incidence and long-term consequences of PBC recurrence after LT.METHODS: We performed a retrospective cohort study in 780 patients transplanted for PBC, between 1983-2017 in 16 centers (9 countries), and followed-up for a median of 11 years. Among them, 190 received preventive UDCA (10-15 mg/kg/day). The primary outcome was histological evidence of PBC recurrence. The secondary outcomes were graft loss, liver-related death, and all-cause death. The association between preventive UDCA and outcomes was quantified using multivariable-adjusted Cox and restricted mean survival time (RMST) models.RESULTS: While recurrence of PBC significantly shortened graft and patient survival, preventive exposure to UDCA was associated with reduced risk of PBC recurrence (adjusted hazard ratio [aHR] 0.41; 95% CI 0.28-0.61; p <0.0001), graft loss (aHR 0.33; 95% CI 0.13-0.82; p <0.05), liver-related death (aHR 0.46; 95% CI 0.22-0.98; p <0.05), and all-cause death (aHR 0.69; 95% CI 0.49-0.96; p <0.05). On RMST analysis, preventive UDCA led to a survival gain of 2.26 years (95% CI 1.28-3.25) over a period of 20 years. Exposure to cyclosporine rather than tacrolimus had a complementary protective effect alongside preventive UDCA, reducing the cumulative incidence of PBC recurrence and all-cause death.CONCLUSIONS: Preventive UDCA after LT for PBC is associated with a reduced risk of disease recurrence, graft loss, and death. A regimen combining cyclosporine and preventive UDCA is associated with the lowest risk of PBC recurrence and mortality.LAY SUMMARY: Recurrence of primary biliary cholangitis after liver transplantation is frequent and can impair graft and patient survival. We performed the largest international study of transplanted patients with primary biliary cholangitis to date. Preventive administration of ursodeoxycholic acid after liver transplantation was associated with reduced risk of disease recurrence, graft loss, liver-related and all-cause mortality. A regimen combining cyclosporine and preventive ursodeoxycholic acid was associated with the best outcomes.

U2 - 10.1016/j.jhep.2020.03.043

DO - 10.1016/j.jhep.2020.03.043

M3 - SCORING: Journal article

C2 - 32275981

VL - 73

SP - 559

EP - 565

JO - J HEPATOL

JF - J HEPATOL

SN - 0168-8278

IS - 3

ER -