Document Detail

Alkaline phosphatase normalization is associated with better prognosis in primary sclerosing cholangitis.
MedLine Citation:
PMID:  21251891     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Primary sclerosing cholangitis results in elevated but fluctuating serum alkaline phosphatase levels that occasionally return to normal.
AIMS: To investigate the frequency of normalization of alkaline phosphatase in newly diagnosed primary sclerosing cholangitis patients and the subsequent clinical outcomes.
METHODS: Records of newly diagnosed primary sclerosing cholangitis patients were examined retrospectively for laboratory values and clinical end points (cholangiocarcinoma, liver transplantation and death) within 10 years of diagnosis. Data from a recent prospective ursodeoxycholic acid treatment trial were also studied.
RESULTS: Eighty-seven patients met the inclusion criteria. Normalization of alkaline phosphatase was seen in 35 (40%) patients. Five (14%) patients with normalization reached an end point whereas 17 (33%) of the patients with persistent elevation reached an end point (P = 0.02). Ursodeoxycholic acid was used similarly by both groups. When the investigative criteria were applied to a prospective trial, there was again a significant relationship between normalization of alkaline phosphatase and survival in patients receiving ursodeoxycholic acid (P < 0.01) and the placebo group (P = 0.02).
CONCLUSIONS: Serum alkaline phosphatase was found to normalize in a high proportion of newly diagnosed primary sclerosing cholangitis patients. This was significantly associated with a better prognosis in a retrospective cohort and when data from a prospective treatment trial was evaluated.
Peter P Stanich; Einar Björnsson; Andrea A Gossard; Felicity Enders; Roberta Jorgensen; Keith D Lindor
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-01-19
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  43     ISSN:  1878-3562     ISO Abbreviation:  Dig Liver Dis     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-07     Completed Date:  2011-07-27     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  309-13     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Department of Medicine, Mayo Clinic, Rochester, MN 55901, United States.
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MeSH Terms
Alkaline Phosphatase / blood*
Biological Markers / blood*
Cholangitis, Sclerosing / drug therapy,  enzymology
Kaplan-Meier Estimate
Middle Aged
Proportional Hazards Models
Prospective Studies
Reference Values
Retrospective Studies
Survival Rate
Ursodeoxycholic Acid / therapeutic use*
Grant Support
Reg. No./Substance:
0/Biological Markers; 128-13-2/Ursodeoxycholic Acid; EC Phosphatase
Comment In:
Dig Liver Dis. 2011 Apr;43(4):268-9   [PMID:  21345755 ]

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