The majority of PBC patients are asymptomatic at the time of diagnosis, and the clinical course is typically slow and progressive, but can differ significantly among individuals 1, 2.
Primary biliary cholangitis (PBC) is an autoimmune chronic liver disease, which is characterized by destruction of the intrahepatic bile ducts, resulting in cholestasis and progressive fibrosis. The ALBI score/grade, derived from objective blood tests, and the Mayo score were superior prognostic tools in PBC patients. The ALBI score showed the highest AUROCs within 2 years after the start of observation beyond 2 years, however, the Mayo score had better prognostic ability for mortality and liver transplantation. Time-dependent ROC analysis showed that the ALBI score has higher the areas under the ROC curves (AUROCs) than the Child–Pugh (C–P) score at each time point AUROCs at 3, 5, and 10 years after the start of follow-up were 0.94, 0.91, and 0.90 for the ALBI score, and 0.89, 0.88, and 0.82 for the C–P score, respectively. During the follow-up period, 60 patients died, 45 due to liver-related diseases and 15 due to non-liver-related diseases, and 16 patients underwent liver transplantation. The predictive performances of the ALBI score and other well-established prognostic scores were compared using time-dependent receiver operating characteristic (ROC) analysis. In this study, a total of 409 patients with primary biliary cholangitis (PBC) were enrolled between March 1990 and October 2018. The albumin–bilirubin (ALBI) score is calculated using only serum albumin and bilirubin levels, and was developed as a simple method to assess hepatic function.