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. 2011 Apr;43(4):309-13.
doi: 10.1016/j.dld.2010.12.008. Epub 2011 Jan 19.

Alkaline phosphatase normalization is associated with better prognosis in primary sclerosing cholangitis

Peter P Stanich  1 , Einar Björnsson, Andrea A Gossard, Felicity Enders, Roberta Jorgensen, Keith D Lindor
Affiliations

Alkaline phosphatase normalization is associated with better prognosis in primary sclerosing cholangitis

Peter P Stanich et al. Dig Liver Dis. 2011 Apr.

Abstract

Background: Primary sclerosing cholangitis results in elevated but fluctuating serum alkaline phosphatase levels that occasionally return to normal.

Aims: To investigate the frequency of normalization of alkaline phosphatase in newly diagnosed primary sclerosing cholangitis patients and the subsequent clinical outcomes.

Methods: Records of newly diagnosed primary sclerosing cholangitis patients were examined retrospectively for laboratory values and clinical end points (cholangiocarcinoma, liver transplantation and death) within 10 years of diagnosis. Data from a recent prospective ursodeoxycholic acid treatment trial were also studied.

Results: Eighty-seven patients met the inclusion criteria. Normalization of alkaline phosphatase was seen in 35 (40%) patients. Five (14%) patients with normalization reached an end point whereas 17 (33%) of the patients with persistent elevation reached an end point (P = 0.02). Ursodeoxycholic acid was used similarly by both groups. When the investigative criteria were applied to a prospective trial, there was again a significant relationship between normalization of alkaline phosphatase and survival in patients receiving ursodeoxycholic acid (P < 0.01) and the placebo group (P = 0.02).

Conclusions: Serum alkaline phosphatase was found to normalize in a high proportion of newly diagnosed primary sclerosing cholangitis patients. This was significantly associated with a better prognosis in a retrospective cohort and when data from a prospective treatment trial was evaluated.

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Figures

Figure 1
Figure 1
Kaplan-Meier analysis of end point-free survival for patients that experienced normalization of alkaline phosphatase (solid line) and patients with persistently abnormal alkaline phosphatase (dashed line) demarcated by years (P=0.02).
See this image and copyright information in PMC

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References

    1. Thorpe MEC, Scheuer PJ, Sherock S. Primary sclerosing cholangitis, the biliary tree and ulcerative colitis. Gut. 1967;8:435–448. - PMC - PubMed
    1. Bambha K, Kim WR, Talwalkar J, et al. Incidence, clinical spectrum, and outcomes of primary sclerosing cholangitis in a United States community. Gastroenterology. 2003 Nov;125(5):1364–1169. - PubMed
    1. Graziadei IW, Wiesner RH, Marotta PJ, et al. Long-term results of patients undergoing liver transplantation for primary sclerosing cholangitis. Hepatology. 1999;30:1121–1127. - PubMed
    1. Kim WR, Therneau TM, Wiesner RH, et al. A revised natural history model for primary sclerosing cholangitis. Mayo Clinic Proceedings. 2000;75:688–694. - PubMed
    1. Poupon RE, Bonnand AM, Chrétien Y, et al. Ten-year survival in ursodeoxycholic acid-treated patients with primary biliary cirrhosis. The UDCA-PBC Study Group. Hepatology. 1999 Jun;29(6):1668–1671. - PubMed

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