Alkaline Phosphatase and Total Bilirubin Predict Survival in Primary Biliary Cirrhosis

Previous studies suggest that alkaline phosphatase (ALP) and total bilirubin (TB) levels predict outcomes in primary biliary cirrhosis (PBC). However, most of these studies were small, which limits their power to define specific ALP and TB thresholds.

To validate the use of ALP and TB levels as surrogate measures of outcomes in PBC and better define their predictive thresholds, researchers analyzed individual data from 4845 participants of 15 long-term, follow-up studies conducted in Europe and North America. ALP and TB levels were obtained at baseline and at different time points throughout the follow-up period. Results were analyzed by subgroups defined by age (<45 vs. ≥45 years), histologic activity level, and treatment with ursodeoxychol…