Concomitant gallstone disease was not associated with long-term outcomes in ursodeoxycholic acid-treated patients with primary biliary cholangitis

• Published in: Journal of digestive diseases Vol. 24; no. 6-7; pp. 419 - 426
• Main Authors: Chen, Sha, Li, Meng Qi, Li, Bu Er, Lv, Ting Ting, Li, Shu Xiang, Shan, Shan, Li, Min, Kong, Yuan Yuan, Zhang, Dong, Ma, Hong, Ou, Xiao Juan, You, Hong, Duan, Wei Jia, Jia, Ji Dong
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01-06-2023
• Subjects: Bilirubin; Calculi; Cholangitis; Cholecystectomy; Cholestasis; Cirrhosis; Diabetes mellitus (non-insulin dependent); Gallstones; Liver diseases; Liver transplantation; Medical prognosis; Medical records; Prognosis; Regression analysis; Transplants & implants; Ursodeoxycholic acid; prevalence; risk factors; prognosis; gallstones
• ISSN: 1751-2972; 1751-2980; 1751-2980
• DOI: 10.1111/1751-2980.13207

Primary biliary cholangitis (PBC) is a rare disease characterized by intrahepatic cholestasis, whereas gallstone disease (GD) is common. In this study, we aimed to investigate the prevalence and impact of GD on the prognosis of PBC in China.
Medical records of the PBC patients were retrospectively reviewed and their follow-up data were obtained via regular structured, standardized telephone interviews. GD was defined as gallstones on ultrasonography or a history of cholecystectomy for gallstones. Propensity score matching (PSM) and Cox regression analysis were performed. The primary end-point was liver-related death and/or liver transplantation.
A total of 985 ursodeoxycholic acid (UDCA)-treated PBC patients were enrolled with a median follow-up duration of 5.3 years (range 1.0-20.9 years). Among them, 258 (26.2%) had GD, including 157 (22.9%) of non-cirrhotic and 101 (33.8%) of cirrhotic patients. Compared with PBC without GD, those with GD were older, more often had type 2 diabetes mellitus, and had a more severe liver disease at baseline. After PSM (1:2), 229 PBC patients with GD were matched with 458 PBC patients without GD based on age, sex, cirrhosis, and total bilirubin level. The transplant-free survival and incidence of hepatic events were similar between the two groups. Furthermore, multivariate Cox regression analysis showed that concomitant GD was not independently associated with a worse prognosis for PBC patients.
Concomitant GD was common but was not associated with long-term outcomes in patients with UDCA-treated PBC.