PRO-C3 and ADAPT Algorithm Accurately Identify Patients with Advanced Fibrosis Due to Alcohol-related Liver Disease

Overview

Journal Aliment Pharmacol Ther

Specialties Gastroenterology
Pharmacology

Date 2021 Jul 12

PMID 34251031

Citations 9

Authors

Bjorn S Madsen

Maja Thiele

Sonke Detlefsen

Maria Kjaergaard

Linda S Moller

Jonel Trebicka

Mette J Nielsen

Natasja Staehr Gudmann

Diana J Leeming

Morten A Karsdal

Aleksander Krag

Affiliations

Soon will be listed here.

Abstract

Background: Alcohol is a main cause of preventable deaths and frequently leads to the development of alcohol-related liver disease. Due to the lack of diagnostics, patients are commonly diagnosed after developing clinical manifestations. Recently, the biomarker PRO-C3 was shown to accurately identify fibrosis due to non-alcoholic fatty liver disease.

Aim: To assess the diagnostic accuracy of PRO-C3, the ADAPT score and best-performing non-patented serological test to detect advanced alcohol-related liver fibrosis.

Methods: We enrolled 426 patients with alcohol overuse in a prospective biopsy-controlled study. We evaluated the accuracy of PRO-C3 and the PRO-C3-based algorithm ADAPT to detect advanced liver fibrosis.

Results: The accuracy of PRO-C3 was good with an AUROC of 0.85 (95% CI 0.79-0.90). The best-performing non-patented test was the Forns index with an AUROC of 0.83 (95% CI 0.78-0.89). The ADAPT algorithm performed better as compared to both the Forns index and PRO-C3 alone with an AUROC = 0.88 (95% CI 0.83-0.93).

Conclusion: PRO-C3 is a new marker with high accuracy to detect advanced alcohol-related liver fibrosis. The diagnostic accuracy of PRO-C3 can be further improved by using the ADAPT algorithm in which the test outperforms currently available non-patented serological fibrosis markers. The study is registered in the Odense Patient Data Exploratory Network (OPEN) under study identification numbers OP_040 (https://open.rsyd.dk/OpenProjects/da/openProject.jsp?openNo=40) and OP_239 (https://open.rsyd.dk/OpenProjects/openProject.jsp?openNo=239&lang=da).

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