Clinical characterization of patients with primary biliary cholangitis: A report from multiple Canadian centres

Eric M. Yoshida, Mark Gordon Swain, Cynthia Tsien, Edward Tam, Robert James Bailey, Dusanka Grbic, Hin Hin Ko, Alnoor Ramji, Nir Hilzenrat, Magdy Elkhashab, Euiseok Kim, Meaghan O’brien, Marco Amedeo Puglia, Kevork M. Peltekian

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Primary biliary cholangitis (PBC) is a rare, chronic autoimmune, cholestatic liver disease affecting approximately 318 per million Canadians. There is limited information regarding the characterization of this patient population in Canada. Consequently, we aim to describe a cohort of PBC patients managed across liver centres serving this type of population. METHODS: A cross-sectional examination of 1,125 PBC patient charts at 15 liver centres across Canada was conducted between January 2016 and September 2017. RESULTS: Data from 1,125 eligible patients were collected from 7 Canadian provinces. The patient population was largely female (90.2%), had a median overall age of 61.3 years, and a median overall time since diagnosis of 6.4 years. Of the patients included in the study, 89% were on ursodeoxycholic acid (UDCA) therapy at a median dose of 14.0 mg/kg/day and 4.4% were previously treated with UDCA, whereas 6.6% were never treated with UDCA. Of the patients with available data (n = 1067), 289 (27.1%) presented with alkaline phosphatase (ALP) levels ≥200 IU/L and/or total bilirubin levels ≥21 µmol/L. Assessment of UDCA treatment response revealed that 26.6% and 38.3% of patients were inadequate responders according to the Toronto and Paris-II criteria, respectively. Mortality occurred in 1.2% (14) of patients, with liver-related adverse outcomes being more commonly observed in patients who discontinued UDCA compared to those who are currently on treatment (36.3% and 19.6%, respectively). CONCLUSION: This study showed that Canadian PBC patients present with demographics and features commonly reported in the literature for this disease. Over one third of PBC patients had inadequate response to UDCA treatment or were not currently being treated with UDCA. Consequently, there is a significant unmet therapeutic need in this Canadian PBC population.

Original languageEnglish
Pages (from-to)372-387
Number of pages16
JournalCanadian Liver Journal
Issue number3
StatePublished - 1 Aug 2022
Externally publishedYes


  • Canada
  • autoimmune liver disease
  • characterization
  • chart audit
  • management
  • national
  • primary biliary cholangitis
  • retrospective
  • ursodeoxycholic acid

ASJC Scopus subject areas

  • Hepatology


Dive into the research topics of 'Clinical characterization of patients with primary biliary cholangitis: A report from multiple Canadian centres'. Together they form a unique fingerprint.

Cite this