LAUSR

Introduction In May 2017, a service evaluation of the management of primary biliary cholangitis in Aneurin Bevan University Health Board was performed. The evaluation identified three groups of patients: 1) non-responders to optimal ursodeoxycholic acid (UDCA), 2) patients on sub-optimal UDCA ( Methods Of 112 patients evaluated in 2017, 30 were identified for review of their management. 11, 15, and 4 patients were in groups 1, 2, and 3 respectively. Clinical letters, weight, medications, and liver biochemistry results of these 30 patients were reviewed again in January 2020. Treatment response to UDCA was assessed using the Toronto criteria (ALP of >1.67 the upper limit of normal). Optimal UDCA therapy was considered to be ≥15 mg/kg based on most recent patient weight available. Results UDCA-non-responders (n=11) 3 did not have information available since 2017; 1 since deceased and 2 did not attend follow-up. Of the 8 reviewed 5 now have an ALP Sub-optimal UDCA patients (n=15) 2 did not have information available since 2017, both deceased. Of the 13 reviewed, 8 had an ALP Patients intolerant to UDCA (n=4) 2 patients have since died, and 1 was discharged due to old age and frailty. 1 patient would be eligible for OCA if pruritus resolves. Discussion Of the 22 patients that were reviewed, 13 now have an ALP