Current and promising therapy for primary biliary cholangitis

Andrea A. Gossard, Keith Lindor

Research output: Contribution to journalReview article

Abstract

Introduction: Primary biliary cholangitis is a chronic, cholestatic liver disease that may progress to cirrhosis with complications of end-stage liver disease. Approved treatment options include ursodeoxycholic acid (UDCA) and obeticholic acid (OCA) but novel therapies are being investigated. Areas covered: In this review, the authors describe the current pharmacotherapy for the treatment of primary biliary cholangitis (PBC) and for management of side effects such as pruritus and fatigue based on the currently available literature. Expert opinion: Patients diagnosed with PBC should be offered treatment with UDCA at 13–15 mg/kg per day if liver enzymes are elevated. If they do not meet the defined criteria of response, adjunctive therapy should be considered. This may include OCA at 5 mg per day for patients without cirrhosis or investigational therapy. Management of the most common side effects, pruritus, and fatigue, is nuanced and includes lifestyle modifications as well as pharmacological approaches. Several tools such as the Mayo Risk Score and GLOBE are available for prognostic modeling. Ultimately, patients with PBC may end up requiring liver transplantation and referral to a transplant center may also be needed.

Original languageEnglish (US)
Pages (from-to)1161-1167
Number of pages7
JournalExpert Opinion on Pharmacotherapy
Volume20
Issue number9
DOIs
StatePublished - Jun 13 2019
Externally publishedYes

Fingerprint

Cholangitis
Ursodeoxycholic Acid
Pruritus
Fatigue
Fibrosis
Therapeutics
Investigational Therapies
End Stage Liver Disease
Expert Testimony
Liver Transplantation
Life Style
Liver Diseases
Referral and Consultation
Pharmacology
Transplants
Drug Therapy
Liver
Enzymes

Keywords

  • cholestatic liver disease
  • liver disease
  • Primary biliary cholangitis
  • UDCA

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Current and promising therapy for primary biliary cholangitis. / Gossard, Andrea A.; Lindor, Keith.

In: Expert Opinion on Pharmacotherapy, Vol. 20, No. 9, 13.06.2019, p. 1161-1167.

Research output: Contribution to journalReview article

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