Current and Emerging Therapies for Primary Biliary Cholangitis
Author Information
Author(s): Warsop Zakary, Anand Nikhil, Al Maliki Husam, De Souza Shuell, Kamyab Arya, Al Hadad Amin, Alrubaiy Laith
Primary Institution: Imperial College London
Hypothesis
This study aims to provide an up-to-date literature review of the effectiveness of first- and second-line treatments as well as emerging novel therapies for primary biliary cholangitis (PBC).
Conclusion
UDCA should remain the treatment of choice for PBC, though perhaps not as monotherapy, and with further investigation, bezafibrate shows promise as a new second-line therapy alongside obeticholic acid.
Supporting Evidence
- UDCA has been well established as a long-term, safe therapy within the literature.
- Despite improving biochemical markers, up to 30–40% of patients are refractory to UDCA.
- Bezafibrate shows promise as a prospective second-line therapy option.
- OCA is effective in UDCA non-responders as shown by the large POISE and COBALT trials.
- Seladelpar and elafibranor are novel agents that have shown efficacy in PBC treatment.
Takeaway
This study looks at how to treat a liver disease called primary biliary cholangitis, showing that one medicine works best, but there are new options that might help more people feel better.
Methodology
A literature search was conducted using Pubmed, Ovid Medline, and SCOPUS to provide a narrative review of first-line, second-line, and emerging therapies in PBC.
Limitations
The review may be confounded by coexisting diseases such as autoimmune hepatitis overlap and does not discuss treatments for symptomatic management of PBC.
Participant Demographics
PBC is ten times more common in middle-aged women, with a prevalence of approximately 20–35/100,000 in the UK.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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