为了在治疗前识别优质毒胆酸（UDCA）反应不佳的患者，提供及时和积极的干预，开发了优质毒胆酸反应评分（URS）。然而，有必要验证该评分在亚洲人口中的有效性。我们分析了2007年至2016年在韩国七所学术机构诊断为原发性胆汁性胆管炎（PBC）并开始UDCA治疗的173名亚洲患者，以验证URS的表现。UDCA反应被定义为经过1年的UDCA治疗后碱性磷酸酶水平低于正常上限的1.67倍。此外，评估了URS对肝相关事件的预测表现，包括新发生的肝功能衰竭或肝细胞癌。在经过1年的UDCA治疗后，133名患者（76.9％）达到UDCA治疗反应。在URS≥1.41（n = 76）的患者中，UDCA反应率为98.7％，在URS <1.41（n = 97）的患者中为58.8％。URS在预测UDCA反应方面的受试者工作特征曲线下面积为0.84（95％置信区间，0.78至0.88）。在中位6.5年的随访期间，18名患者（10.4％）出现肝相关事件。在117名经组织学评估为PBC I-III阶段的患者中，根据URS，5年肝相关事件无进展生存率有所不同；URS≥1.41为100％，URS <1.41为86.5％（p = 0.005）。URS在预测亚洲PBC患者的UDCA治疗反应方面表现良好。此外，在PBC阶段中，根据URS的风险存在差异。因此，URS可用于预测PBC患者的反应和临床结果。

The ursodeoxycholic acid (UDCA) response score (URS) was developed to identify poor responders to UDCA before treatment, in order to offer timely and proactive intervention. However, validation of the URS in Asian population is warranted.A total of 173 Asian patients diagnosed with primary biliary cholangitis (PBC) between 2007 and 2016 at seven academic institutions in Korea who started UDCA treatment were analyzed to validate the performance of URS. UDCA response was defined as an alkaline phosphatase level less than 1.67 times the upper limit of normal after 1-year of UDCA treatment. In addition, prognostic performance of URS for liver-related events, defined as newly developed hepatic decompensation or hepatocellular carcinoma was evaluated.After 1 year of UDCA treatment, 133 patients (76.9%) achieved UDCA response. UDCA response rate was 98.7% for those with URS ≥1.41 (n=76) and 58.8% for those with URS <1.41 (n=97). The area under the receiver operating characteristic curve of URS in predicting UDCA response was 0.84 (95% confidence interval, 0.78 to 0.88). During a median follow-up of 6.5 years, liver-related events developed in 18 patients (10.4%). Among 117 patients with PBC stage I-III by histological evaluation, the 5-year liver-related event-free survival rate differed according to the URS; 100% for URS ≥1.41 and 86.5% for URS <1.41 (p=0.005).URS demonstrated good performance in predicting a UDCA treatment response in Asian PBC patients. In addition, the risk of liver-related events differed according to the URS for the PBC stage. Thus, URS can be used to predict the response and clinical outcome in patients with PBC.