Primary sclerosing cholangitis: A review and update on therapeutic developments

James H. Tabibian, Keith Lindor

Research output: Contribution to journalReview article

45 Scopus citations

Abstract

Primary sclerosing cholangitis (PSC) is a chronic, cholestatic, idiopathic liver disease characterized by fibro-obliterative inflammation of the hepatic bile ducts. In a clinically significant proportion of patients, PSC progresses to cirrhosis, end-stage liver disease, and in some cases, cholangiocarcinoma. Despite clinical trials of nearly 20 different pharmacotherapies over several decades, safe and effective medical therapy, albeit critically needed, remains to be established. PSC is pathogenically complex, with genetic, immune, enteric microbial, environmental and other factors being potentially involved and, thus, not surprisingly, it manifests as a clinically heterogeneous disease with a relatively unpredictable course. It is likely that this complexity and clinical heterogeneity are responsible for the negative results of clinical trials, but novel insights about and approaches to PSC may shift this trend. The authors herein provide a review of previously tested pharmacologic agents, discuss emerging fundamental concepts and present viewpoints regarding how identifying therapies for PSC may evolve over the next several years.

Original languageEnglish (US)
Pages (from-to)103-114
Number of pages12
JournalExpert Review of Gastroenterology and Hepatology
Volume7
Issue number2
DOIs
StatePublished - Feb 1 2013

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Keywords

  • TOR serine-threonine kinases
  • antibacterial agents
  • bile duct diseases
  • cholangiography
  • cholangiopancreatography
  • endoscopic retrograde
  • enterohepatic circulation
  • fibrosis
  • genes
  • magnetic resonance imaging
  • ras

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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