Corpechot, Christophe;
Carrat, Fabrice;
Gaouar, Farid;
Chau, Frederic;
Hirschfield, Gideon;
Gulamhusein, Aliya;
Montano-Loza, Aldo J;
... de Ledinghen, Victor; + view all
(2022)
Liver stiffness measurement by vibration-controlled transient elastography improves outcome prediction in primary biliary cholangitis.
Journal of Hepatology
, 77
(6)
pp. 1545-1553.
10.1016/j.jhep.2022.06.017.
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Corpechot et al. - 2022 - Liver stiffness measurement by vibration-controlle.pdf - Accepted Version Download (3MB) | Preview |
Abstract
BACKGROUND & AIMS: Liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) has been shown to predict outcomes of patients with primary biliary cholangitis (PBC) in small-size studies. We aimed to validate the prognostic value of LSM in a large cohort study. METHODS: We performed an international, multicentre, retrospective follow-up study of 3,985 patients with PBC seen at 23 centres in 12 countries. Eligibility criteria included at least 1 reliable LSM by VCTE and a follow-up ≥ 1 year. Independent derivation (n = 2,740) and validation (n = 568) cohorts were built. The primary endpoint was time to poor clinical outcomes defined as liver-related complications, liver transplantation, or death. Hazard ratios (HRs) with CIs were determined using a time-dependent multivariable Cox regression analysis. RESULTS: LSM was independently associated with poor clinical outcomes in the derivation (5,324 LSMs, mean follow-up 5.0 ± 3.1 years) and validation (1,470 LSMs, mean follow-up 5.0 ± 2.8 years) cohorts: adjusted HRs (95% CI) per additional kPa were 1.040 (1.026–1.054) and 1.042 (1.029–1.056), respectively (p <0.0001 for both). Adjusted C-statistics (95% CI) at baseline were 0.83 (0.79–0.87) and 0.92 (0.89–0.95), respectively. Between 5 and 30 kPa, the log-HR increased as a monotonic function of LSM. The predictive value of LSM was stable in time. LSM improved the prognostic ability of biochemical response criteria, fibrosis scores, and prognostic scores. The 8 kPa and 15 kPa cut-offs optimally separated low-, medium-, and high-risk groups. Forty percent of patients were at medium to high risk according to LSM. CONCLUSIONS: LSM by VCTE is a major, independent, validated predictor of PBC outcome. Its value as a surrogate endpoint for clinical benefit in PBC should be considered.
Type: | Article |
---|---|
Title: | Liver stiffness measurement by vibration-controlled transient elastography improves outcome prediction in primary biliary cholangitis |
Location: | Netherlands |
Open access status: | An open access version is available from UCL Discovery |
DOI: | 10.1016/j.jhep.2022.06.017 |
Publisher version: | https://doi.org/10.1016/j.jhep.2022.06.017 |
Language: | English |
Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
Keywords: | PBC; FibroScan; Mortality; Transplantation; Prognosis |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
URI: | https://discovery.ucl.ac.uk/id/eprint/10183631 |
1. | United Kingdom | 5 |
2. | United States | 3 |
3. | Italy | 2 |
4. | Russian Federation | 2 |
5. | Sweden | 1 |
6. | Mexico | 1 |
7. | China | 1 |
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