For many patients with primary biliary cirrhosis (PBC), alkaline phosphatase (ALP) levels continue to rise despite intervention with current standard of care therapy. In a study of treatment response to ursodeoxycholic acid (UDCA), rates of histologic progression were significantly lower in the responder group when compared with nonresponders. Failure to respond to UDCA may result in progression to liver failure, indicating a need for alternative intervention.1-3

ELEVATED ALP MAY SIGNAL INADEQUATE RESPONSE TO TREATMENT

Explore studies that reinforce the importance of closely monitoring ALP to help manage PBC.1-8

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PBC MAY BE A FAMILY MATTER

In an NIH study, the prevalence of PBC was significantly higher in first-degree relatives.9,10 Find out more about the importance of screening in this group.

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THE EARLIER, THE BETTER

See how early intervention may reduce progression to cirrhosis, potentially improving outcomes in patients diagnosed with PBC.11

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References:  1. Kumagi T, Guindi M, Fischer SE, et al. Baseline ductopenia and treatment response predict long-term histological progression in primary biliary cirrhosis. Am J Gastroenterol. 2010;105(10):2186-2194. doi:10.1038/ajg.2010.216.  2. Corpechot C, Carrat F, Poupon R, Poupon R-E. Primary biliary cirrhosis: incidence and predictive factors of cirrhosis development in ursodiol-treated patients. Gastroenterology. 2002;122(3):652-658. doi:10.1053/gast.2002.31880.  3. Corpechot C, Chazouilléres O, Poupon R. Early primary biliary cirrhosis: biochemical response to treatment and prediction of long-term outcome. J Hepatol. 2011;55(6):1361-1367. doi:10.1016/j.jhep.2011.02.031.  4. Parés A, Caballería L, Rodés J. Excellent long-term survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic acid. Gastroenterology. 2006;130(3):715-720. doi:10.1053/j.gastro.2005.12.029.  5. Corpechot C, Abenavoli L, Rabahi N, et al. Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis. Hepatology. 2008;48(3):871-877. doi:10.1002/hep.22428.  6. Kuiper EMM, Hansen BE, De Vries RA, et al. Improved prognosis of patients with primary biliary cirrhosis that have a biochemical response to ursodeoxycholic acid. Gastroenterology. 2009;136(4):1281-1287. doi:10.1053/j.gastro.2009.01.003.  7. Kumagi T, Meaney C, Al-Harthy N, et al. The Toronto Western Hospital PBC Study: North American validation of biochemical predictors of long-term survival. Hepatology. 2010;52(suppl 4):482A-483A. Abstract 324.  8. Momah N, Silveira MG, Jorgensen R, Sinakos E, Lindor KD. Optimizing biochemical markers as endpoints for clinical trials in primary biliary cirrhosis. Liver Int. 2012;32(5):790-795. doi:10.1111/j.1478-3231.2011.02678.x.  9. Poupon R. Primary biliary cirrhosis: a 2010 update. J Hepatol. 2010;52(5):745-758. doi:10.1016/j.jhep.2009.11.027.  10. Gershwin ME, Selmi C, Worman HJ, et al; USA PBC Epidemiology Group. Risk factors and comorbidities in primary biliary cirrhosis: a controlled interview-based study of 1032 patients. Hepatology. 2005;42(5):1194-1202. doi:10.1002/hep.20907.  11. Corpechot C, Carrat F, Bonnand A-M, Poupon RE, Poupon R. The effect of ursodeoxycholic acid on liver fibrosis progression in primary biliary cirrhosis. Hepatology. 2000;32(6):1196-1199. doi:10.1053/jhep.2000.20240.