Primary biliary cholangitis review – new management strategies emerge

Abstract

Primary biliary cholangitis (PBC) is an autoimmune, cholestatic liver disease that disproportionately affects middle- to older-aged women. It is progressive and, left untreated, results in biliary cirrhosis and portal hypertension, with ensuing complications of ascites, variceal bleeds, hepatic encephalopathy, and, ultimately, death.¹ Since 1997, ursodeoxycholic acid (UDCA) has been approved for managing PBC, significantly influencing the rate of progression and, in turn, adverse outcomes.^2-4 Up to 40% of patients will suboptimally respond to first-line treatment with UDCA, requiring add-on therapy.⁵ Despite this, PBC as an indication for transplant has declined significantly over the past decades, highlighting the impact of improved management and therapeutic options.²