Background & Aims: Normalization of serum alkaline phosphatase (SAP) was recently shown to correlate with better prognosis in Primary Sclerosing Cholangitis (PSC). We aimed at evaluating the impact of SAP improvement to below 1.5 the upper limit of normal (ULN) on the prognosis of this cholestatic liver disease.
Methods: Oxford PSC database was screened for cases diagnosed between 1980 and 2004. Cases which met the inclusion criteria were retrospectively examined for clinical parameters, laboratory values, and clinical end points (liver decompensation, liver transplantation, and liver-related deaths including cholangiocarcinoma). Cases were followed-up to 31/12/2010.
Results: 139 patients were included, (87 males). Improvement of SAP to below 1.5 ULN was achieved by 55 (40%) patients in a median time of 2 years, compared to 84 (60%) who did not. 3/55 (6%) patients with SAP improvement reached an end point compared to 32/84 (38%) patients with no SAP improvement (p <0.0001). 13/84 (15%) patients with no SAP improvement developed cholangiocarcinoma compared to no cholangiocarcinoma in the group with SAP improvement (p = 0.002). The end point free survival was significantly longer in patients with SAP improvement (p <0.0001). The significance of SAP improvement as a predictor of prognosis persisted after controlling for other clinical and laboratory variables. Improvement of SAP to below 1.5 ULN was comparable to complete normalization of SAP in terms of prognosis.
Conclusions: Improvement in SAP to below 1.5 ULN is associated with better outcome and reduced risk of CCA in PSC. This was comparable to the achievement of complete normalization of SAP.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jhep.2012.10.013 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Role of Locoregional Therapy on Survival After Living Donor Liver Transplantation for Hepatocellular Carcinoma--Experience from a High-volume Center.
J Clin Exp Hepatol
December 2024
Max Centre for Liver and Biliary Sciences, Max Super Specialty Hospital, Saket, New Delhi 110017, India.
Background: Locoregional therapy (LRT) in patients with hepatocellular carcinoma (HCC) before liver transplantation (LT) has a role in improving the tumor biology and post-LT survival outcome apart from downstaging and bridging. We retrospectively analyzed our database of adult living donor liver transplants (LDLT) for HCC, to compare the survival outcomes in Group-1 (upfront-LT, HCC within Milan/UCSF/AFP<1000 ng/ml) and Group-2 (LT post-LRT, HCC beyond UCSF/irrespective of tumor burden with AFP>1000 ng/ml). We also explored the risk factors for recurrence on follow-up.
View Article and Find Full Text PDFInterferon activation in bone marrow long-lived plasma cells in systemic lupus erythematosus.
Front Immunol
January 2025
Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, Rochester, NY, United States.
While durable antibody responses from long-lived plasma cell (LLPC) populations are important for protection against pathogens, LLPC may be harmful if they produce antibodies against self-proteins or self-nuclear antigens as occurs in autoimmune diseases such as systemic lupus erythematosus (SLE). Thus, the elimination of autoreactive LLPC may improve the treatment of antibody-driven autoimmune diseases. However, LLPC remain a challenging therapeutic target.
View Article and Find Full Text PDFEffect of seeds on Glycated hemoglobin, Cardiovascular disease risks and dyslipidemia in Type-2 diabetic patients in Karachi: A non-blind randomized controlled trial.
Pak J Med Sci
January 2025
Sadia Anwer Research Student, Biochemistry, Federal Urdu University of Arts, Science & Technology, Karachi, Pakistan.
Objective: To explore the effect of seeds powder { 500 mg} capsule in diabetes Type-2 (T2DM) patients in Karachi.
Methods: A randomized selection of 40 T2DM patients from Sindh Government Hospital New Karachi with their consents was done for a non-blinded controlled trial from October to December 2019 and divided into P (Positive Control, metformin 500 mg) & T (Test, + was also included, using the same dosage of CapCASP on twenty healthy volunteers. The data were analyzed using an online graph pad student's t-test and a one-way ANOVA (SPSS version 24) metformin 500mg each).
Effect of hybrid blood purification on nutritional status, inflammation, and cardiovascular events in patients with end-stage renal disease.
Pak J Med Sci
January 2025
Rong Zou Department of Nephrology, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province 421002, P.R. China.
Objective: To explore the effects of hybrid blood purification on nutritional status and cardiovascular events in patients with end-stage renal disease (ESRD).
Methods: A total of 135 patients with ESRD who received treatment in The Affiliated Nanhua Hospital of Hengyang Medical School from March 2021 to June 2023 were included in this retrospective study. Of them, 66 patients were treated with hemodialysis purification (hemodialysis group), and 69 patients underwent hybrid blood purification (hybrid group).
Randomized controlled trial on the treatment of Hypoferritinemia without Anemia: Comparing oral and intravenous iron supplementation among reproductive age women in Pakistan.
Pak J Med Sci
January 2025
Dr. Rubeena Zakar, MBBS, PhD Public Health, Department of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore, Pakistan.
Background & Objectives: Hypoferritinemia without anemia (HWA) is an under-recognized public health concern. Early identification and targeted treatment of HWA can prevent unnecessary medication use and potential drug abuse. This study aims to establish clearer guidelines for recognizing and managing HWA, improving patient's outcome.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!