Time course of histological progression in primary sclerosing cholangitis

Paul Angulo, Dirk R. Larson, Terry M Therneau, Nicholas F La Russo, Kenneth P. Batts, Keith D. Lindor

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

OBJECTIVE: The aim of this study was to determine the time course over which patients with primary sclerosing cholangitis (PSC) progress through the histological stages of the disease. METHODS: One hundred seven patients with PSC who had at least two liver biopsies were identified. The stage information from two consecutive biopsies formed one observation and a continuous time Markov model was used to describe the rate of progression between biopsies. RESULTS: Three hundred seven liver biopsies were performed in the 107 patients giving a total of 200 observations. At 1 yr, 42% of patients in stage II disease progress, 66% at 2 yr, and 93% at 5 yr; whereas 14% of patients in stage III progress at 1 yr, 25% at 2 yr, and 52% at 5 yr. The frequency of progression of stage I disease could not be determined because of the small number of patients in stage I. Regression of histological stage was observed in 30 of 200 total observations (15%), and in 30 of 85 observations (35%) in which there was a change in stage. CONCLUSIONS: These data regarding histological progression in PSC may be potentially helpful in determining the number of patients and length of time necessary to appreciate a treatment effect in clinical trials. However, the high degree of sampling variability in PSC may restrict the usefulness of serial liver biopsies as a means of evaluating treatment efficacy.

Original languageEnglish (US)
Pages (from-to)3310-3313
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume94
Issue number11
DOIs
StatePublished - Nov 1999

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Sclerosing Cholangitis
Biopsy
Liver
Observation
Clinical Trials

ASJC Scopus subject areas

  • Gastroenterology

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Time course of histological progression in primary sclerosing cholangitis. / Angulo, Paul; Larson, Dirk R.; Therneau, Terry M; La Russo, Nicholas F; Batts, Kenneth P.; Lindor, Keith D.

In: American Journal of Gastroenterology, Vol. 94, No. 11, 11.1999, p. 3310-3313.

Research output: Contribution to journalArticle

Angulo, Paul ; Larson, Dirk R. ; Therneau, Terry M ; La Russo, Nicholas F ; Batts, Kenneth P. ; Lindor, Keith D. / Time course of histological progression in primary sclerosing cholangitis. In: American Journal of Gastroenterology. 1999 ; Vol. 94, No. 11. pp. 3310-3313.
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