Ursodeoxycholic acid response criteria (PBC)

Reports which definitions of biochemical response to ursodeoxycholic acid a patient meets.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Months on ursodeoxycholic acid
12
Alkaline phosphatase now
240 U/L
Alkaline phosphatase upper limit of normal
120 U/L
Alkaline phosphatase before treatment
500 U/L
AST
60 U/L
AST upper limit of normal
40 U/L
Total bilirubin
0.8 mg/dL

Result: a response by Barcelona and Paris I, not by Paris II

The tool opens with these values already filled in. Replace them with your own.

What the result means

Barcelona, 12 months
Alkaline phosphatase falls more than 40% from baseline, or normalizes.
Paris I, 12 months
Alkaline phosphatase at or below 3 times the upper limit of normal, AST at or below 2 times, bilirubin at or below 1 mg/dL.
Paris II, 12 months
The same three tightened to 1.5 times, 1.5 times and 1 mg/dL, drawn on early-stage disease.
Toronto, 24 months
Alkaline phosphatase at or below 1.67 times the upper limit of normal.
They disagree
Each set was drawn on a different cohort against a different endpoint, so one blood draw can be a response by one set and not by another.
What it is for
Non-response identifies who is considered for second-line therapy. It is not a treatment decision and not a reason to stop ursodeoxycholic acid.

What you enter

  • Months on ursodeoxycholic acid (the time point is part of each criterion)
  • Alkaline phosphatase now
  • Alkaline phosphatase upper limit of normal
  • Alkaline phosphatase before treatment (Barcelona only)
  • AST (the Paris sets only)
  • AST upper limit of normal
  • Total bilirubin (the Paris sets only)
How this is calculated

Corpechot C, Abenavoli L, Rabahi N, et al. Hepatology. 2008;48(3):871-877 (Paris I); Corpechot C, et al. J Hepatol. 2011;55(6):1361-1367 (Paris II); Pares A, et al. Gastroenterology. 2006;130(3):715-720 (Barcelona); Kumagi T, et al. Am J Gastroenterol. 2010;105(10):2186-2194 (Toronto). Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.