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How is PBC treatment changing?
Watch experts discuss recent data and rethinking PBC management.
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IN “STABLE”a PATIENTS WITH PBC, RISK IS A LOT CLOSER THAN YOU THINK1,b

How will you rethink your treatment goals to help your patients with primary biliary cholangitis (PBC)?

Rethink your treatment of PBC by learning about PBC progression and ways to reduce the risk of liver transplant or death for your patients.2,3

“Stable”a patients are still in danger of disease progression1,b

Lowering prognostic markers can reduce risk and improve survival, but recent evidence demonstrates current ALP and bilirubin benchmarks may not be enough and updated information from the Global PBC Study Groupc could be considered2,3:

  • The prognostic value of ALP and bilirubin below the ULN
  • Regular assessment of fibrosis
  • a The term “stable” is used to describe PBC patients whose biomarkers have been decreased to thresholds above ULN, but remain persistent and are not increasing.
  • b In a prospective cohort study (N=187; median follow-up of 5.8 years), liver biomarkers for PBC patients improved prominently within the first 3 months of UDCA treatment and then stayed relatively stable (above the ULN) for the following months. Some patients experienced an adverse outcome (ie, liver-related death, liver transplantation, or complications of cirrhosis) despite achieving biochemical response with UDCA.1
  • c The Global PBC Study Group is an international collaboration of 17 centers across Europe and North America that aims to identify reliable surrogate endpoints in PBC using patient data from long-term follow-up cohorts.2
  • ALP, alkaline phosphatase; UDCA, ursodeoxycholic acid; ULN, upper limit of normal.

References:
1. Zhang LN, Shi TY, Shi XH, et al. Early biochemical response to ursodeoxycholic acid and long-term prognosis of primary biliary cirrhosis: results of a 14-year cohort study. Hepatology. 2013;58(1):264-272. 2. Murillo Perez CF, Harms MH, Lindor KD, et al; the GLOBAL PBC Study Group. Goals of treatment for improved survival in primary biliary cholangitis: treatment target should be bilirubin within the normal range and normalization of alkaline phosphatase. Am J Gastroenterol. 2020;115(7):1066-1074. 3. Murillo Perez CF, Hirschfield GM, Corpechot C, et al; the GLOBAL PBC Study Group. Fibrosis stage is an independent predictor of outcome in primary biliary cholangitis despite biochemical treatment response. Aliment Pharmacol Ther. 2019;50(10):1127-1136.