Research: ALP and the ELF score in PSC Clinical Trials
Summary for Patients
On 21 July, research about alkaline phosphatase and the enhanced liver fibrosis score and PSC was published.
One of the challenges in proving whether a new drug works is the fact that things like liver transplantation, development of cancer, or attacks of cholangitis are difficult to predict from the moment someone is diagnosed with PSC.
This means that doctors are constantly looking for early signals that a new medicine is working, most often in the blood tests that are performed during routine hospital visits. One of the most commonly tested ‘biomarkers’ is alkaline phosphatase, or ALP. Some studies have suggested that groups of individuals who have lower ALP values in blood are less likely to need a transplant later in life, whereas other works show that people still experience progression in liver disease despite lowering ALP (for instance, whilst taking medicines like ursodeoxycholic acid).
One of the reasons for the different findings between studies could be due to the fact that ALP readings vary between hospital visits. Up till now the amount of variation between blood test readings have not been analysed among patients with PSC.
Based on: Trivedi PJ, Muir AJ, Levy C, Bowlus CL, Manns M, Lu X, Crans G, Chung C, Subramanian GM, Myers RP, Goodman Z, Chalasani N, Vierling JM, Guha IN, Hirschfield GM. Inter-and Intra-individual Variation, and Limited Prognostic Utility, of Serum Alkaline Phosphatase in a Trial of Patients With Primary Sclerosing Cholangitis. Clinical Gastroenterology and Hepatology. 2020 Jul 22.