Primary sclerosing cholangitis, part 1: Epidemiology, etiopathogenesis, clinical features, and treatment

James H. Tabibian, Ahmad H. Ali, Keith Lindor

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Primary sclerosing cholangitis (PSC) is a chronic, idiopathic cholangiopathy that can progress to cirrhosis, end-stage liver disease, hepatobiliary cancer, and/or colorectal cancer. The course of PSC is often complicated by portal hypertension, symptoms of cholestasis, and recurrent bacterial cholangitis, among other conditions, with a consequent decrease in survival (median, approximately 20 years) and quality of life. The etiopathogenesis of PSC remains poorly understood, and, as such, pharmacotherapy has yet to be definitively established. Despite its rarity, PSC is the fifth leading indication for liver transplantation (LT) in the United States. Although the only intervention known to extend survival of patients with PSC, LT is costly and invasive, and recurrent PSC affects approximately 30% of LT recipients. Over the past several years, owing in part to progress in the understanding of PSC, novel pharmacotherapeutics have been developed, some of which are currently in the PSC clinical trial pipeline. Here, in the first of a 2-part series, we provide a review and update of the epidemiology, etiopathogenesis, clinical features, and treatment of PSC. The second part of the series will focus on cancer risk, prevention, and surveillance of PSC.

Original languageEnglish (US)
Pages (from-to)293-304
Number of pages12
JournalGastroenterology and Hepatology
Volume14
Issue number5
StatePublished - May 1 2018

Fingerprint

Sclerosing Cholangitis
Epidemiology
Liver Transplantation
Therapeutics
End Stage Liver Disease
Cholangitis
Survival
Cholestasis
Portal Hypertension
Colorectal Neoplasms
Neoplasms
Fibrosis
Quality of Life
Clinical Trials
Drug Therapy

Keywords

  • Cirrhosis
  • Colorectal cancer
  • Hepatobiliary cancer
  • Inflammatory bowel disease
  • Liver transplantation
  • Microbiome
  • Primary sclerosing cholangitis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Primary sclerosing cholangitis, part 1 : Epidemiology, etiopathogenesis, clinical features, and treatment. / Tabibian, James H.; Ali, Ahmad H.; Lindor, Keith.

In: Gastroenterology and Hepatology, Vol. 14, No. 5, 01.05.2018, p. 293-304.

Research output: Contribution to journalArticle

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