In this issue (see page 121), Lueschner and colleagues extend previous reports regarding factors that predict biochemical normalisation in patients with primary biliary cirrhosis (PBC) being treated with ursodeoxycholic acid (UDCA).1 This study differs from others in having a much longer follow up period, an unusually large percentage of patients with early stage disease, and intensive evaluation during the follow up, including extensive biochemical, immunoserological, tumour marker, HLA typing, and histological evaluations.

They found, perhaps not surprisingly, that the less abnormal the tests initially, the more likely they were to become normal eventually on treatment and, perhaps even more obviously, the patients who had the best response after one year of treatment were most likely to have test values within the normal range when follow up was extended. They also noted histological improvement and the suggestion that symptoms improve in those patients in whom biochemical tests return to normal. …