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27-03-2024 | Primary Biliary Cholangitis | Review

Primary Biliary Cholangitis: Updates in Management and Goals of Treatment

Authors: Kaitlyn Carlson, Madeleine Hines Salge, George Cholankeril

Published in: Current Hepatology Reports

Abstract

Purpose of Review

Primary biliary cholangitis (PBC) is a chronic autoimmune disease of the liver characterized by cholestasis and destruction of bile ducts. Goals of treatment include normalization of liver enzymes and prevention of progression to cirrhosis as well as symptom control. The purpose of this review is to summarize the current state of treatment of primary biliary cholangitis.

Recent Findings

In 2021, AASLD released a statement recommending fibrates as an off-label alternative for PBC patients with inadequate response or contraindications to approved therapies. Caution should be used when considering OCA in advanced liver disease. Multiple other therapies for PBC are in phase III trials including PPAR agonists and IBAT inhibitors.

Summary

There are two FDA-approved treatments for primary biliary cholangitis, ursodeoxycholic acid (UDCA) and obeticholic acid (OCA). Obeticholic acid is used when there is inadequate response to UDCA, and fibrates can also be considered as off-label alternatives in the setting of inadequate response to first-line therapy. Several other classes of drugs are in development for primary biliary cholangitis including multiple in phase III trials.

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Title: Primary Biliary Cholangitis: Updates in Management and Goals of Treatment
Authors: Kaitlyn Carlson
Madeleine Hines Salge
George Cholankeril
Publication date: 27-03-2024
Publisher: Springer US
Keywords: Primary Biliary Cholangitis
Fibrates
Published in: Current Hepatology Reports
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-024-00667-2

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