Lu M, et al. - In order to examine epidemiologic factors and treatment of primary biliary cholangitis (PBC) in the United States (US), the clinicians aimed to analyze data from the Fibrotic Liver Disease (FOLD) consortium, from 11 geographically diverse health systems. Significant differences were observed in PBC prevalence and treatment by sex, race, and age.

• From 2003 through 2014, the clinicians developed a validated electronic health record-based classification model to identify patients with PBC in the FOLD consortium database.
• Multivariable modeling was used to evaluate the effects of factors associated with PBC prevalence and treatment with ursodeoxycholic acid (UDCA).

• A total of 4,241 PBC cases were identified among over 14.5 million participants in the FOLD consortium health systems, followed for a median 5 years.
• The classification model identified patients with PBC with an area under the receiver operating characteristic curve value of 93%, with 94% sensitivity and 87% specificity.
• The average patient age at diagnosis was found to be 60 years; among these, 21% were reported to be Hispanic, 8% were African American, and 7% were Asian American/American Indian/Pacific Islander.
• Increased levels of alkaline phosphatase was found in half of the cohort (49%) and 70% were treated with UDCA.
• The estimated 12-year prevalence of PBC was 29.3 per 100,000 persons.
• Highest adjusted prevalence values were noted among women (42.8 per 100,000), White patients (29.6 per 100,000), and patients 60–70 yrs old (44.7 per 100,000).
• Among men and African Americans (10.7 and 19.7 per 100,000, respectively), prevalence was significantly lower.
• Moreover, men and African Americans were less inclined to receive UDCA treatment than women or Whites (odds ratios, 0.6 and 0.5, respectively; P<.05).