Autoimmune diseases

Ursodeoxycholic Acid May Improve OS Among African Americans With PBC

Ursodeoxycholic acid (UDCA) treatment can significantly lower the mortality rate and improve overall survival (OS) among African Americans with primary biliary cholangitis (PBC), according to a new analysis of data from the Fibrotic Liver Disease Consortium.

The researchers analyzed data from baseline through December 31, 2016, to evaluate the treatment’s impact across race/ethnicity, gender, and clinical status among 4238 patients with PBC. Of these, 8% were African American, 7% were Asian American/American Indian/Pacific Island (ASINPI), and 21% were Hispanic. Furthermore, 13% were men, and 78% had ever received UDCA treatment.


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The study authors evaluated the association between treatment, mortality, and liver transplant/death among these patients.

Of those who had never received UDCA treatment, African Americans and ASINPIs had higher mortality than whites. However, among patients who had received UDCA treatment, African Americans and ASINPIs had lower mortality than whites.

Similar patterns were observed for liver transplant/death. All patient groups experienced a reduction in liver transplant/death risk with the use of UDCA. And except for white women with an aspartate aminotransferase/alanine aminotransferase ratio of 1.1 or greater, all groups experienced a reduction in mortality risk with the use of UDCA.

Compared with patients with a low-normal bilirubin level at baseline (≤0.4 mg/dL), patients with a high-normal (1.0 > 0.7 mg/dL) or a mid-normal bilirubin (0.7 > 0.4 mg/dL) level had significantly higher liver transplant/death and all-cause mortality.

—Colleen Murphy

Reference:

Gordon SC, Wu H, Lindor K, et al; FOLD Investigators. Ursodeoxycholic acid treatment preferentially improves overall survival among African Americans with primary biliary cholangitis [published online January 27, 2020]. Am J Gastroenterol. doi:10.14309/ajg.0000000000000512.