Background and Aims: The GLOBE score differentiates PBC patients into high- and low risk groups for death or liver transplantation after 1 year of UDCA therapy using age-specific thresholds. We sought to determine whether the GLOBE score is predictive for death and liver transplantation when used over time in patients of different age- categories. Methods: Data from the Global PBC Study Group was used. Every 6 months starting at 1 yearof UDCA therapy we identified patients who passed their age-specific GLOBE score thresholds (aGLOBE-t) (ages <45, 45–52, 52–58, 58–66, and ≥66 years, with thresholds− 0.52, 0.01, 0.60, 1.01 and 1.69, respectively). For those passing their aGLOBE-t and those patients who did not, time to a combined endpoint of liver transplantation (LT) and death were compared with POSTER PRESENTATIONS JOURNAL OF HEPATOLOGY Journal of Hepatology 2017 vol. 66 | S543 – S750 © 2017 All rights reserved. Cox-proportional hazards analysis with aGLOBE-t as a time-depend- ent covariate. Results: A total of 4340 UDCA-treated PBC patients were included, 924 (21.3%), 885 (20.4%), 875 (20.2%), 876 (20.2%), 780 (18%) in age categories <45 (A), 45 – 52 (B), 52 – 58 (C), 58 – 66 (D), and ≥ 66 (E), respectively. At 12 months of UDCA therapy a total of 1244 (28.7%) patients passed their aGLOBE-t, 375 (40.6%), 279 (31.5%), 207 (23.7%), 208 (23.7%), and 175 (22.4%) in age categories A-E, respectively. Within the following 10 years there were an additional 841 (46.7%) patients that passed their aGLOBE-t, 183 (41.6%), 163 (45.7%), 172 (46.5%), 156 (41.1%), and 167 (40.6%) within age categories A-E, respectively (Fig 1.) The effect (time-dependent hazard ratio (HR)) on the clinical endpoint (death or LT) of passing the aGLOBE-t during follow-up, in patients that were characterized as low risk patients at 12 months of UDCA therapy, but passed theiraGLOBE-t during further follow-up, was HR 4.9 (95% confidence interval [CI]: 1.4 – 17.2), HR 3.7 (1.1 – 9.7), 4.3 (2.3 – 8.1), 3.7 (2.2 – 6.0) and 3.0 (2.1 – 4.3) in age categories A-E, respectively. Conclusions: Patients of different age-categories with a beneficial GLOBE score at 12 months of UDCA therapy are at significant risk of death or LT when they pass their age-specific GLOBE score threshold during further follow-up
The GLOBE score identifies PBC patients at increased risk of liver transplantation or death in different age-categories over time / J.C. Goet, W.J. Lammers, A. Floreani, A. Pares, H.L.A. Janssen, G.M. Hirschfield, H.R. Van Buuren, C. Corpechot, P. Invernizzi, K.D. Lindor, M.J. Mayo, P.M. Battezzati, F. Nevens, A.L. Mason, K.V. Kowdley, C.Y. Ponsioen, T. Bruns, G.N. Dalekos, D. Thorburn, X. Verhelst, N.K. Gatselis, P.J. Trivedi, R. Poupon, B.E. Hansen. - In: JOURNAL OF HEPATOLOGY. - ISSN 0168-8278. - 66:1(2017), pp. SAT-368.S543-SAT-368.S544. ((Intervento presentato al 52. convegno International Liver Congress Annual Meeting of the European Association for the Study of the Liver tenutosi a Amsterdam nel 2017 [10.1016/S0168-8278(17)31494-0].
The GLOBE score identifies PBC patients at increased risk of liver transplantation or death in different age-categories over time
P.M. Battezzati;
2017
Abstract
Background and Aims: The GLOBE score differentiates PBC patients into high- and low risk groups for death or liver transplantation after 1 year of UDCA therapy using age-specific thresholds. We sought to determine whether the GLOBE score is predictive for death and liver transplantation when used over time in patients of different age- categories. Methods: Data from the Global PBC Study Group was used. Every 6 months starting at 1 yearof UDCA therapy we identified patients who passed their age-specific GLOBE score thresholds (aGLOBE-t) (ages <45, 45–52, 52–58, 58–66, and ≥66 years, with thresholds− 0.52, 0.01, 0.60, 1.01 and 1.69, respectively). For those passing their aGLOBE-t and those patients who did not, time to a combined endpoint of liver transplantation (LT) and death were compared with POSTER PRESENTATIONS JOURNAL OF HEPATOLOGY Journal of Hepatology 2017 vol. 66 | S543 – S750 © 2017 All rights reserved. Cox-proportional hazards analysis with aGLOBE-t as a time-depend- ent covariate. Results: A total of 4340 UDCA-treated PBC patients were included, 924 (21.3%), 885 (20.4%), 875 (20.2%), 876 (20.2%), 780 (18%) in age categories <45 (A), 45 – 52 (B), 52 – 58 (C), 58 – 66 (D), and ≥ 66 (E), respectively. At 12 months of UDCA therapy a total of 1244 (28.7%) patients passed their aGLOBE-t, 375 (40.6%), 279 (31.5%), 207 (23.7%), 208 (23.7%), and 175 (22.4%) in age categories A-E, respectively. Within the following 10 years there were an additional 841 (46.7%) patients that passed their aGLOBE-t, 183 (41.6%), 163 (45.7%), 172 (46.5%), 156 (41.1%), and 167 (40.6%) within age categories A-E, respectively (Fig 1.) The effect (time-dependent hazard ratio (HR)) on the clinical endpoint (death or LT) of passing the aGLOBE-t during follow-up, in patients that were characterized as low risk patients at 12 months of UDCA therapy, but passed theiraGLOBE-t during further follow-up, was HR 4.9 (95% confidence interval [CI]: 1.4 – 17.2), HR 3.7 (1.1 – 9.7), 4.3 (2.3 – 8.1), 3.7 (2.2 – 6.0) and 3.0 (2.1 – 4.3) in age categories A-E, respectively. Conclusions: Patients of different age-categories with a beneficial GLOBE score at 12 months of UDCA therapy are at significant risk of death or LT when they pass their age-specific GLOBE score threshold during further follow-up
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