Primary Biliary Cirrhosis - AST to Platelet Ratio Index (APRI) & Response to UDCA Therapy for Risk Stratification

Patient selection: primary biliary cirrhosis

Parameters for baseline APRI:

(1) serum AST in IU/L

(2) upper limit of normal reference range for AST

(3) platelet count (as factor * 10^9/L)

AST to platelet ratio index = APRI =

= ((serum AST) / (upper limit of normal for AST)) / (factor from platelet count) * 100 =

= 100 * (serum AST) / ((upper limit normal AST) * (factor for platelet count))

An APRI > 0.54 is associated with increased risk for liver transplant or death.

The APRI can be combined with the biochemical response to ursodeoxycholic acid therapy after 1 year.

The best outcome occurred in biochemical responders with APRI <= 0.54 (around 9% with poor outcome.

The worst outcome occurred in nonresponders with APRI > 0.54 at baseline (around 60-80% with poor response, depending on criteria for biochemical response).

A nonresponder with an APRI <= 0.54 had a better outcome than a responder with an APRI > 0.54 at baseline.