P-103 AN ELEVATED BASELINE LEVEL OF ALKALINE PHOSPHATASE, ALANINE AMINOTRANSFERASE, AND ASPARTATE AMINOTRANSFERASE PREDICT A LACK OF BIOCHEMICAL RESPONSE TO UDCA THERAPY AMONG HISPANIC PATIENTS LIVING WITH PRIMARY BILIARY CHOLANGITIS

Abstract

Conflict of interest: No Introduction and Objectives: Primary biliary cholangitis (PBC) is a chronic, progressive, autoimmune liver disease characterized by the destruction of the small bile ducts within the liver. Ursodeoxycholic acid (UDCA) is the first-line treatment for PBC, shown to improve liver biochemistry and delay disease progression. However, the response to UDCA therapy is variable among patients, with some failing to achieve a satisfactory biochemical response. Identifying predictors of non-response is crucial for optimizing treatment strategies and improving patient outcomes. Recent evidence has shown a lower biochemical response among patients of Hispanic ethnicity, which is often underrepresented in clinical research. The findings have significant implications for clinical practice, and are of particular interest in countries that have limited access to liver transplantation. Patients / Materials and Methods: This is a single center, retrospective, propensity score-matched cohort study, which included all patients with PBC confirmed by liver biopsy that were followed by the hepatology clinic from January 1st, 2015 to March 1st 2024 under treatment with UDCA. A biochemical response was defined according to the Toronto criteria, with an alkaline phosphatase (ALP) 2 x ULN (OR 5.3, 95% CI [2.433, 11.649], p ULN (OR 5.3, 95% CI [2.429, 11.845], p ULN (OR 7.8, 95% CI [3.554, 17.159] p<0.001). All of these variables remained ss after multivariate regression analysis. Conclusions: Among patients with PBC that receive initial therapy with UDCA, a baseline increased ALP, AST and ALT are associated with an incomplete biochemical response, identifying patients that might benefit from early initiation of additional therapies. Prospective studies are needed.