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Ursodiol treatment improves survival in many patients with primary biliary cirrhosis (PBC) but not all. Poor response to ursodiol is predicted by elevated serum total bilirubin levels, advanced histologic stage, and the presence of interface hepatitis. However, these markers have limitations: Only a minority of patients with PBC have elevated bilirubin levels at baseline, and histologic staging requires invasive biopsy. Now, using data from a cohort study in France, investigators have studied the natural history of PBC in ursodiol-treated patients. They have discovered biochemical responses that, when present in treated patients, predict improved outcomes on ursodiol therapy.
In this cohort study, 292 patients with PBC received 13–15 mg/kg/d…