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Review of Medical Management of Primary Biliary Cholangitis
S D Med. 2021 Dec;74(12):562-568.
Govarthanan Rajendiran12, Charoen Mankongpaisarnrung12, Marco A Olivera-Martinez3, Timothy M McCashland4
Sanford USD Medical Center, Sioux Falls, South Dakota.
Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
Transplant Hepatology Associate Program, Division of Gastroenterology and Transplant Hepatology, University of Nebraska Medical Center, Omaha, Nebraska.
Transplant Hepatology Program, University of Nebraska Medical Center, Omaha, Nebraska.
Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease with presumed autoimmune etiology. Current treatment options include ursodeoxycholic acid, obeticholic acid, and fibrate, which target mainly cholestasis. There is no effective therapy against autoimmune or hepatic fibrosis components. We can still achieve adequate biochemical response with monotherapy or a combination of medications in non-cirrhotic and compensated cirrhotic PBC patients. Several criteria are available for risk stratification and assess treatment response. Liver stiffness measurement by transient elastography is also a useful tool for evaluating disease progression. Lack of treatment or inadequate response are predictors of poor outcome. There is a strong need for additional therapies for PBC.