Publications by authors named "Simone Muniz Carvalho Fernandes da Cunha"
Alkaline phosphatase and liver fibrosis at diagnosis are associated with deep response to ursodeoxycholic acid in primary biliary cholangitis.
Clin Res Hepatol Gastroenterol
October 2024
Objective: Primary biliary cholangitis is a chronic and progressive autoimmune liver disease, whose prognosis can be improved by normalizing alkaline phosphatase and bilirubin. While ursodeoxycholic acid (UDCA) is first line standard of care, approximately 40 % of patients exhibit incomplete response. We aimed to identify prognostic markers for deep response to UDCA therapy at presentation.
View Article and Find Full Text PDFA new and simple score to predict adequate and deep response to ursodeoxycholic acid in patients with primary biliary cholangitis: the ALP-A score.
Eur J Gastroenterol Hepatol
May 2024
Background: Ursodeoxycholic acid (UDCA) is the standard treatment for primary biliary cholangitis (PBC), but a significant proportion of patients do not respond adequately, leading to increased risk of adverse outcomes. This study aims to develop a new and straightforward predictive score to identify PBC patients likely to achieve a complete response to UDCA.
Methods: A logistic regression analysis was conducted using a derivation cohort of PBC patients to identify pre-treatment variables associated with response to UDCA.
Risk factors for cancer in patients with primary biliary cholangitis and autoimmune hepatitis and primary biliary cholangitis overlap syndrome.
Ann Hepatol
June 2023
Article Synopsis
- PBC and AIH/PBC are linked to an increased risk of hepatocellular carcinoma (HCC) and extra-hepatic malignancy (EHM), prompting a study to identify cancer risk factors in these patients.
- The study analyzed data from 752 PBC patients, finding 87 cancer cases, including 20 HCC and 67 EHM, with notable associations between HCC and factors like cirrhosis, smoking, and certain medications.
- Cirrhosis, obesity, and past azathioprine therapy were identified as independent risk factors for HCC, while Sjogren syndrome and psoriasis correlated with EHM; overall, EHM prevalence was higher in PBC patients compared to HCC.
Response to Ursodeoxycholic Acid May Be Assessed Earlier to Allow Second-Line Therapy in Patients with Unresponsive Primary Biliary Cholangitis.
Dig Dis Sci
February 2023
Background: Response to ursodeoxycholic acid (UDCA) in primary biliary cholangitis (PBC) has been traditionally assessed 1 to 2 years after treatment initiation. With the development of new drugs, some patients may benefit from an earlier introduction of second-line therapies.
Aims: This study aims to identify whether well-validated response criteria could correctly identify individuals likely to benefit from add-on second-line therapy at 6 months.
Clinical features and treatment outcomes of primary biliary cholangitis in a highly admixed population.
Ann Hepatol
March 2022
Article Synopsis
- This study focuses on primary biliary cholangitis (PBC) in non-white populations, specifically analyzing Brazilian patients to assess their clinical features and treatment outcomes.
- The research included 562 predominantly female patients, revealing that after an average follow-up of 6.2 years, a significant portion experienced advanced liver disease, and most were treated with ursodeoxycholic acid (UDCA), with some requiring additional treatments.
- Findings indicate that while PBC features in Brazilian patients are similar to those in Caucasian and Asian populations, the response to UDCA therapy was lower than expected and varied widely, highlighting the need for standardization in treatment evaluation.
Anti-mitochondrial Antibody-Negative Primary Biliary Cholangitis Is Part of the Same Spectrum of Classical Primary Biliary Cholangitis.
Dig Dis Sci
July 2022
Background: Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease in which anti-mitochondrial antibodies (AMA) are the diagnostic hallmark. Whether AMA-negative PBC patients represent a different phenotype of disease is highly debated.
Aims: The purpose of our study was to compare AMA-positive and AMA-negative PBC patients in a large non-white admixed Brazilian cohort.