Primary Biliary Cirrhosis: Questions and Promises
Authors: Keith D. Lindor
Journal: Annals of Internal Medicine (1997)

Editorials1 May 1997Primary Biliary Cirrhosis: Questions and PromisesKeith D. Lindor, MDKeith D. Lindor, MDMayo Clinic, Rochester, MN 55905Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-9-199705010-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The article on biochemical and histologic remission of primary biliary cirrhosis in response to medical treatment by Kaplan and colleagues [1] in this issue may be a landmark contribution. The authors force the reader to deal with a series of provocative issues, including redefinition of our understanding of the natural history of primary biliary cirrhosis and reevaluation of appropriate clinical end points for trials of treatment in this disease. They also raise the possibility that primary biliary cirrhosis is heterogeneous and should be further subtyped.The natural history of primary biliary cirrhosis is extremely long and may extend over decades. ...References1. Kaplan MM, DeLellis RA, Wolfe HJ. Sustained biochemical and histologic remission of primary biliary cirrhosis in response to medical treatment. Ann Intern Med. 1997; 126:682-8. Google Scholar2. Metcalf JV, Mitchison HC, Palmer JM, Jones DE, Bassendine MF, James OF. Natural history of early primary biliary cirrhosis. Lancet. 1996; 348:1399-402. Google Scholar3. Dickson ER, Grambsch PM, Fleming TR, Fisher LD, Langworthy A. Prognosis in primary biliary cirrhosis: model for decision making. Hepatology. 1989; 10:1-7. Google Scholar4. Christensen E, Altman DG, Neuberger J, De Stavola BL, Tygstrup N, Williams R. Updating prognosis in primary biliary cirrhosis using a time-dependent Cox regression model. PBC1 and PBC2 trial groups. Gastroenterology. 1993; 105:1865-76. 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Olsson R, Hagerstrand I, Broome U, Danielsson A, Jarnerot G, Loof L, et al. Sampling variability of percutaneous liver biopsy in primary sclerosing cholangitis. J Clin Pathol. 1995; 48:933-5. Google Scholar11. Poupon RE, Poupon R, Balkau B. Ursodiol for long-term treatment of primary biliary cirrhosis. The UDCA-PBC Study Group. N Engl J Med. 1994; 330:1342-7. Google Scholar12. Heathcote EJ, Cauch-Dudek K, Walker V, Bailey RJ, Blendis LM, Ghent CN, et al. The Canadian Multicenter Double-Blind Randomized Controlled Trial of ursodeoxycholic acid in primary biliary cirrhosis. Hepatology. 1994; 19:1149-56. Google Scholar13. Lindor KD, Therneau TM, Jorgensen RA, Malinchoc M, Dickson ER. Effects of ursodeoxycholic acid on survival in patients with primary biliary cirrhosis. Gastroenterology. 1996; 110:1515-8. Google Scholar14. Kaplan MM, Alling DW, Zimmerman HJ, Wolfe HJ, Sepersky RA, Hirsch GS, et al. A prospective trial of colchicine for primary biliary cirrhosis. N Engl J Med. 1986; 315:1448-54. Google Scholar15. Zifroni A, Schaffner F. Long-term follow-up of patients with primary biliary cirrhosis on colchicine therapy. Hepatology. 1991; 14:990-3. Google Scholar16. Lindor KD, Dickson ER, Jorgensen RA, Anderson ML, Wiesner RH, Gores GJ, et al. The combination of ursodeoxycholic acid and methotrexate for patients with primary biliary cirrhosis: the results of a pilot study. Hepatology. 1995; 22:1158-62. Google Scholar17. Janes CH, Lindor KD. Outcome of patients hospitalized for complications after outpatient liver biopsy. Ann Intern Med. 1993; 118:96-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: Mayo Clinic, Rochester, MN 55905Corresponding Author: Keith D. Lindor, MD, Division of Gastroenterology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSustained Biochemical and Histologic Remission of Primary Biliary Cirrhosis in Response to Medical Treatment Marshall M. Kaplan , Ronald A. DeLellis , and Hubert J. Wolfe Metrics Cited byNatural history of pruritus in primary biliary cirrhosisCReliability and Validity of the NIDDK-QA Instrument in the Assessment of Quality of Life in Ambulatory Patients With Cholestatic Liver DiseaseRandomised controlled trials of ursodeoxycholic-acid therapy for primary biliary cirrhosis: a meta-analysisCirrhose biliaire primitive et sclérodermie systémique (syndrome de Reynolds): à propos de huit nouveaux cas. Apport de la biopsie des glandes salivaires accessoires 1 May 1997Volume 126, Issue 9Page: 733-735KeywordsBiopsyDrugsForecastingHistologyLesionsLiverLiver diseasesLiver transplantationMethotrexatePrimary biliary cirrhosis Issue Published: 1 May 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...