Treatment with ursodeoxycholic acid (UDCA) can result in improvement in liver function tests, including alkaline phosphatase (ALP)1

  • Once diagnosed, all patients should be treated with UDCA; however, a considerable number of patients may have an inadequate response to UDCA1-4
  • In patients with primary biliary cholangitis (PBC) who present with abnormal ALP, treatment with UDCA can result in improvement in liver function tests, including ALP, within a few weeks1
    • 90% of the improvement usually occurs as early as 6 months1
  • About 20% of patients will have normalization of liver biochemistries after 2 years5
    • A further 15% or 35% of the total will have normalization by 5 years1
  • After initiating treatment with UDCA, monitor patients after 3 to 6 months to determine if ALP has been lowered and subsequently monitor every 3 to 6 months1

Are your patients achieving adequate lowering of ALP?

References:  1. Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ. Primary biliary cirrhosis. Hepatology. 2009;50(1):291-308. doi:10.1002/hep.22906. (AASLD guidelines)  2. 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.  3. 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.  4. 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.  5. Jorgensen RA, Dickson ER, Hofmann AF, Rossi SS, Lindor KD. Characterisation of patients with a complete biochemical response to ursodeoxycholic acid. Gut. 1995;36(6):935-938. doi:10.1136/gut.36.6.935.