Thus, a higher PPV suggests more accuracy of a test in identifying patients with good prognosis; a higher NPV suggests more accuracy of a test in identifying patients with poor prognosis; and a lower NLR suggests more accuracy of a test in identifying patients with

poor prognosis. The performance of biochemical response after 3, 6, and 12 months of UDCA therapy for prediction of long-term outcome was assessed (Table 4). We found that biochemical responses at the sixth month may identify patients with good or poor prognosis with no less accuracy than evaluation at 1 year. The former showed higher or the same PPV and NPV and lower NLR than the latter by all definitions tested. In contrast, biochemical responses at the third month demonstrated higher PPV, lower NPV, and increased NLR by all definitions compared with biochemical responses at 1 year. XL765 chemical structure It can be inferred that biochemical responses at the third month were superior in identifying patients with good prognosis, yet were less potent in selecting high-risk patients for therapeutic trials. Our findings are in accordance with and provide more direct evidence to the statement that

therapeutic trials should target patients with incomplete biochemical response after 3 to 6 months of UDCA treatment.11 Our study was limited by small sample size and relatively Roxadustat supplier short duration of follow-up. Another limitation is that a considerable proportion of patients did not strictly follow the regular 3-month examination interval, making biochemical data available for 128 (68.4%) patients for the third month after UDCA treatment, 145 (77.5%) patients for the sixth month, and 157 (84.0%) patients for 1 year. 上海皓元医药股份有限公司 To make full use of the available data, we used all data for the statistical analyses. To avoid bias, we compared the baseline characteristics of patients with or without recorded biochemical data. They did not differ statistically in age, sex, baseline biochemical data, and long-term outcomes

(data not shown). Thus, the influence of missing data would mostly likely not effect the results. The strict criteria for selecting patients at entry, the careful follow-up of patients, and the prospective nature of the collected data can partly compensate for these limitations. The evolution of laboratory liver parameters within the first year of UDCA therapy, the compatibility of biochemical response at 3, 6, and 12 months in discriminating patients with good or poor outcome, and similar prognostic impact of biochemical responses at 6 and 12 months together contributed to our conclusion that an early biochemical response at 6 months would as efficiently identify patients at risk of poor outcome as evaluation at 1 year.