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Emerging therapies for PBC.

Authors
  • Chascsa, David Maxwell Hunter1, 2
  • Lindor, Keith Douglas3
  • 1 Department of Gastroenterology and Hepatology, Mayo Clinic, MD 5777 E. Mayo Blvd, Phoenix, AZ, 85054, USA. [email protected]
  • 2 Department of Transplant Center, Mayo Clinic, MD 5777 E. Mayo Blvd, Phoenix, AZ, 85054, USA. [email protected]
  • 3 Office of University Provost, Arizona State University, MD, 550 North 3rd Street, Phoenix, AZ, 85004, USA. [email protected]
Type
Published Article
Journal
Journal of gastroenterology
Publication Date
Mar 01, 2020
Volume
55
Issue
3
Pages
261–272
Identifiers
DOI: 10.1007/s00535-020-01664-0
PMID: 31970467
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Primary biliary cholangitis is an uncommon cholestatic liver disease predominantly affecting middle-aged women. Left untreated, there is a high risk of progression to end-stage liver disease. Few treatment options exist. To date, ursodeoxycholic acid (UDCA) and obeticholic acid (OCA) are the only medical therapies approved for use, other than symptomatic treatments and liver transplantation, the latter of which is reserved for those developing complications of cirrhosis or with intractable pruritus. UDCA improves outcomes, but many patients do not adequately respond. OCA therapy may improve response, but long-term data are limited. New therapies are desperately needed, but evaluation has been limited by the fact that the disease is heterogeneous, hard end points take years to develop, and there are different criteria in use for determining therapeutic response based on surrogate biomarkers. Fibrates appear to be the most promising new therapy and have beneficially affected surrogate end points and are beginning to show improvement in clinical end points.

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