The Paris criteria were recognized as the best validated and easiest to use.7, 11 Using published criteria, we sought Rapamycin to determine whether a biochemical response as early as 3 to 6 months instead of 1 year would similarly identify patients with poor long-term outcome; if true, it could facilitate a more rapid selection of patients suitable

for new therapeutic approaches. In the present study, we analyzed prospectively collected data of 187 patients with a mean follow-up period of 5.9 years. First, we found that serum bilirubin, ALP, GGT, AST, ALT, and IgM levels most prominently decreased within the first 3 months of UDCA therapy. These laboratory parameters continued to decrease gradually, with the maximum response seen at either 6 months or 1 year. Second, we found that the Paris, Barcelona, Toronto, and Ehime definition applied at 3, 6, and 12 months all significantly buy BGJ398 discriminated the patients

in terms of long-term outcome, whereas no significant association was found with the Rotterdam definition (Table 3 and Fig. 3). Finally, we found that biochemical response at the sixth month can more accurately identify patients with good or poor prognosis compared with that at 1 year. The long-term evolution of laboratory liver parameters beyond 1 year UDCA therapy has been documented, suggesting that biochemical response to UDCA can be maintained for up to 15 years.3, 16 In contrast, laboratory parameters within the first year were seldom reported in a large cohort of patients. Our cohort consisted of 187 patients who were followed at 3-month

intervals. Laboratory investigations were performed and data were collected prospectively. All of the laboratory parameters studied showed a prominent improvement in the first 3 months and then stayed relatively stable for the following months within the first ADAM7 year of UDCA treatment (Fig. 1). This led us to hypothesize that an early biochemical response as short as 3 to 6 months may be used in place of that after 1 year of UDCA therapy. We then evaluated the prognostic impact of multiple criteria in our patients. By all definitions except the Rotterdam criteria, biochemical response at 3, 6, and 12 months significantly discriminated our patients in terms of long-term outcome (Table 3 and Fig. 3). Our results tend to agree with those of the study recently published by the Paris group.14 The Paris group’s study included 165 patients with early PBC, and no significant association was found between the long-term outcomes and the Rotterdam definition. Since the Rotterdam criteria have been demonstrated to be more potent prognostic indicators of long-term outcome in late rather than early stages of PBC,8 they may not be applicable in a cohort of patients that contains high proportions of early PBC.