| Revue: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000409086 |
| ISSN: | 1665-2681 |
| Autores: | Hilscher, Moira1 Enders, Felicity B2 Carey, Elizabeth J3 Lindor, Keith D4 Tabibian, James H3 |
| Instituciones: | 1Mayo Clinic, Department of Internal Medicine, Rochester, Minnesota. Estados Unidos de América 2Mayo Clinic, Division of Biomedical Statistics & Informatics, Rochester, Minnesota. Estados Unidos de América 3Mayo Clinic, Division of Gastroenterology & Hepatology, Scottsdale, Arizona. Estados Unidos de América 4Arizona State University, College of Health Solutions, Phoenix, Arizona. Estados Unidos de América |
| Año: | 2016 |
| Volumen: | 15 |
| Número: | 2 |
| Paginación: | 246-253 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Aplicado, descriptivo |
| Resumen en inglés | Recent studies suggest that serum alkaline phosphatase may represent a prognostic biomarker in patients with primary sclerosing cholangitis. However, this association remains poorly understood. Therefore, the aim of this study was to investigate the prognostic significance and clinical correlates of alkaline phosphatase normalization in primary sclerosing cholangitis. Material Material and methods. and methods. This was a and methods. retrospective cohort study of patients with a new diagnosis of primary sclerosing cholangitis made at an academic medical center. The primary endpoint was time to hepatobiliaryneoplasia, liver transplantation, or liver-related death. Secondary endpoints included occurrence of and time to alkaline phosphatase normalization. Patients who did and did not achieve normalization were compared with respect to clinical characteristics and endpoint-free survival, and the association between normalization and the primary endpoint was assessed with univariate and multivariate Cox proportional-hazards analyses. Eighty-six patients were included in the study, with a total of 755 patient-years of follow-up. Thirty-eight patients (44%) experienced alkaline phosphatase normalization within 12 months of diagnosis. Alkaline phosphatase normalization was associated with longer primary endpoint-free survival (p = 0.0032) and decreased risk of requiring liver transplantation (p = 0.033). Persistent normalization was associated with even fewer adverse endpoints as well as longer survival. In multivariate analyses, alkaline phosphatase normalization (adjusted hazard ratio 0.21, p = 0.012) and baseline bilirubin (adjusted hazard ratio 4.87, p = 0.029) were the only significant predictors of primary endpoint-free survival. Alkaline phosphatase normalization, particularly if persistent, represents a robust biomarker of improved long-term survival and decreased risk of requiring liver |
| Disciplinas: | Medicina |
| Palabras clave: | Diagnóstico, Gastroenterología, Colangitis esclerosante primaria, Colangiocarcinoma, Pruebas serológicas, Biomarcadores, Fosfatasa alcalina, Prognosis |
| Keyword: | Medicine, Diagnosis, Gastroenterology, Primary sclerosing cholangitis, Cholangiocarcinoma, Serological tests, Biomarkers, Alkaline phosphatase, Prognosis |
| Texte intégral: | Texto completo (Ver PDF) |
