Clinical characteristics of patients with primary biliary cholangitis treated with ursodeoxycholic acid.

Introduction:  Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease. Despite established first-line therapy with ursodeoxycholic acid (UDCA), many patients do not achieve biochemical remission. Data on the characteristics of PBC in Poland remain limited.

Objectives:  To characterize demographic, clinical, and serological features of Polish patients with PBC and effect of treatment in a multicenter retrospective study.

Patients And Methods: A total of 364 patients from 10 hepatology centers were included. Data on demographics, laboratory tests, autoantibodies, and markers of disease severity were collected between January 6 and March 8, 2025 and analyzed according to the duration of UDCA treatment (<2 vs. ≥2 years).

Results:  Women constituted 92.3% of the cohort. Most patients were aged 60-80 years, but male patients were relatively more common in the <50 and >80 age groups. Cirrhosis was diagnosed in 35.2% of patients. Anti-mitochondrial antibodies were present in 94.4%, and anti-Ro52 antibodies in 34.1%. Anti-gp210 and anti-sp100 antibodies were more frequent in patients with longer disease duration. No substantial differences in liver biochemistry were found between short- and long-term UDCA groups, except for lower GGT activity with longer treatment. Despite pruritus in 46% of patients, antipruritic therapy was rarely used.

Conclusions:  This is the first national study to characterize PBC in Poland. Findings suggest limited long-term efficacy of UDCA, potential diagnostic delay in men, and unmet needs in symptom management. Anti-gp210, anti-sp100, and anti-Ro52 antibodies may serve as important serologic markers. Prospective studies are needed to confirm these observations.