Editorial: UDCA Dosing in PBC—Between Guideline Adherence and Clinical Reality: Authors' Reply

Le résumé fourni par la source

We thank Dr. Hernández-Evole et al. for their positive evaluation of our manuscript regarding the uptake of anticholestatic therapy in the Dutch population with primary biliary cholangitis (PBC). They agreed that ursodeoxycholic acid (UDCA) dosing should be optimised according to body weight before classifying a patient as insufficient responder and initiation of second-line therapy. It was rightfully questioned, however, whether the dose of UDCA also needs to be optimised in patients who have already achieved complete biochemical response without evidence of disease progression. One may argue that Dutch hepatologists tend to agree as lower UDCA dosages were more frequently prescribed to patients with a complete biochemical response according to Paris II. In this subgroup with a relatively good prognosis, it may be difficult to imagine and/or document an absolute prognostic gain of minor UDCA dose adjustments, at least within the registered follow-up of current (inter-)national datasets. Availability of detailed data on the UDCA dosages over time will most likely be an important hurdle for such an assessment as well. Still, we believe we should continue to promote a uniform UDCA dosage recommendation of at least 13 mg/kg/day for all people affected by PBC. [...]

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.