Abstract: Objective The aim of this study was to analyze factors that impact response to ursodeoxycholic acid (UDCA) therapy in patients with primary biliary cholangitis(PBC). Methods A total of 271 patients with PBC were encountered in First Affiliated Hospital, China Medical University, between January 2019 and December 2023, all underwent liver biopsies, finding liver tissue moderate to severe interface inflammation in 37 cases. Patients received UDCA therapy. Multivariate Logistic regression analysis was applied to reveal independent impacting factors for poor response by end of 1 year of treatment. Results By end of one-year UDCA treatment, complete response (CR) was obtained in 196 cases(72.3%) in our series; percentages of male, serum anti-gp210 positive and liver tissue moderate to severe interface inflammation in patients without CR were 24.0%, 18.7% and 28.0%, all significantly higher than 6.6%, 3.1% and 8.2%(P<0.05) in those with CR; serum ALP, GGT, IgG and γ-globulin levels were (297.6±3.5)U/L, (299.0±23.9)U/L,(16.2±1.5)g/L and (16.5±1.7)%, all much higher than [(50.5±5.8)U/L, (174.9±15.1)U/L, (12.4±1.1)g/L and (8.8±2.0)%,respectively, P<0.05] in those with CR; multivariate Logistic regression analysis showed that liver tissue moderate to severe interface inflammation, high level of serum ALP and serum anti-gp210 positive were all the independent impacting factors for poor response to UDCA therapy (P<0.05). Conclusion Patients with PBC could not response to UDCA treatment completely, especially in those who didn’t meet criteria of overlapping syndrome but with liver tissue moderate to severe interface inflammation, which should be surveyed early and give them appropriate management.

Key words: Primary biliary cholangitis, Ursodeoxycholic acid, Moderate-to-severe interface inflammation, Treatment, Prognosis