Prognostic scores in primary biliary cholangitis patients with advanced disease

Table 1 Baseline cohort characteristics

Baseline cohort characteristic	Value
Age at diagnosis, yr	56.84 (11.2)
Female, n (%)	343 (86.4)
Year of diagnosis, range	2015 to 2021
AMA M2+, n (%)	296 (74.6)
AMA M2-, gp210+, n (%)	98 (24.7)
AMA M2-, sp100+, n (%)	99 (24.9)
Liver biopsy cases, n (pathological stage, using the Scheuer classification)	5 (I), 23 (II), 3 (I-II), 5 (II-III), 14 (III), 4 (III-IV), 77 (IV)
PLT as × 109/L	88 (142, 207)
PT in s	12.2 (13.3, 14.9)
INR	0.96 (1.06, 1.23)
ALB in g/L	29.9 (35.1, 39.9)
ALT in U/L	27 (52, 98)
AST in U/L	40 (68, 120)
TBil in mol/L	15.8 (24.3, 52.3)
CREA in mmol/L	50 (58, 68)
ALP in IU/L	122 (204, 351)
GGT in IU/L	56 (166, 356)
GLOBE	0.34 (1.56, 2.65)
UK-PBC	0.02 (0.07, 0.26)
APRI	0.69 (1.40, 2.54)
FIB4	2.28 (4.36, 6.93)
ALBI	-2.51 (-2.03, -1.39)
Mayo	1.44 (2.33, 3.52)
Without cirrhosis, baseline time/end of the follow-up, n (%)	80 (20.2)/50 (12.6)
Compensated cirrhosis	43 (10.9%)/56 (14.1%)
Decompensated cirrhosis	274 (69.0%)/288 (72.5%)
Death	82
Liver-related death	79
LT	4

The upper limits of normal of each biochemical index in the figure are as follow: platelet (350 × 10⁹/L), prothrombin time (15 s), international normalized ratio (1.3), albumin (50g/L), alanine aminotransferase (40 U/L), aspartate transaminase (40 U/L), total bilirubin (20.5 μmol/L), creatinine (97 mmol/L), alkaline phosphatase (125 IU/L), gamma-glutamyl transferase (32 IU/L. ALB: Albumin; ALBI: Albumin-bilirubin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AMA: Anti-mitochondrial antibody; APRI: Aspartate aminotransferase-to-platelet ratio index; AST: Aspartate transaminase; CREA: Creatinine; FIB4: Fibrosis-4 index; GGT: Gamma-glutamyl transferase; GLOBE: The prognostic score using data from the global primary biliary cholangitis group; INR: International normalized ratio; LT: Liver transplantation; PLT: Platelet; PT: Prothrombin time; TBil: Total bilirubin.

Table 2 Discriminative performance of the various risk prediction scores calculated at baseline and after 1 year of ursodeoxycholic acid therapy

C-statistic at various follow-up time points (95%CI)
Risk prediction model	Baseline	1 yr of UDCA
GLOBE		0.731 (0.681-0.782)
UK-PBC		0.727 (0.678-0.776)
APRI	0.592 (0.536-0.647)	0.347 (0.296-0.398)
FIB4	0.648 (0.593-0.704)	0.680 (0.628-0.732)
ALBI	0.705 (0.656-0.755)	0.725 (0.672-0.778)
Mayo	0.702 (0.653-0.751)	0.740 (0.690-0.791)

ALBI: Albumin-bilirubin; APRI: Aspartate aminotransferase-to-platelet ratio index; C-statistic: Concordance statistic; CI: Confidence interval; FIB4: Fibrosis-4 index; UDCA: Ursodeoxycholic acid.

Table 3 Multivariable analyses of risk prediction scores after 1 year of ursodeoxycholic acid therapy

	Univariate analyses			Multivariable analyses
Prognostic score	Hazard ratio	95%CI	P value	Hazard ratio	95%CI	P value
GLOBE	1.703	1.474-1.967	< 0.001	1.582	1.029-2.433	0.037
UK-PBC	6.046	3.479-10.510	< 0.001	1.012	0.330-3.102	0.983
APRI	0.998	0.971-1.024	0.860	0.918	0.812-1.038	0.171
FIB4	1.005	0.997-1.013	0.242	1.008	0.991-1.024	0.369
ALBI	2.546	1.955-3.316	< 0.001	1.194	0.595-2.40	0.618
Mayo	1.495	1.348-1.676	< 0.001	1.022	0.697-1.497	0.913

ALBI: Albumin-bilirubin; APRI: Aspartate aminotransferase-to-platelet ratio index; CI: Confidence interval; FIB4: Fibrosis-4 index.