Beyond UDCA: Exploring Second-Line Treatments for Primary Biliary Cholangitis
Published: Mar 23, 2024
Medically reviewed by Jerome Albert Ecker | MD, Assistant Professor of Medicine, Duke University - Durham, NC on March 23rd, 2024.
While ursodeoxycholic acid (UDCA) is the go-to treatment for primary biliary cholangitis (PBC), it doesn't work for everyone. Discover the promising second-line therapies offering hope to PBC patients.
Contents
When UDCA Isn't Enough
About 40% of PBC patients don't respond adequately to UDCA alone. This is where second-line treatments come in. These medications are like reinforcements, helping when the first line of defense isn't strong enough.
Obeticholic Acid: The New Kid on the Block
Obeticholic acid (OCA) is a relatively new treatment approved for PBC. It works by activating a receptor called FXR, which helps regulate bile acid production and flow. Think of OCA as a 'traffic controller' for bile acids in your liver. Studies have shown it can improve liver function tests in patients who don't respond well to UDCA.
Fibrates: Dual-Action Defenders
Fibrates, particularly bezafibrate, have shown promise in treating PBC. These drugs, originally used for lowering cholesterol, also have anti-inflammatory effects in the liver. They're like multi-tool Swiss Army knives, tackling PBC from different angles. Some studies suggest fibrates can improve both liver function and symptoms like itching in PBC patients.
Frequently Asked Questions
They're typically used in combination with UDCA.
They can, which is why careful monitoring is important.
It depends on individual factors and response to UDCA.
Availability varies; some may only be accessible through clinical trials.
Key Takeaways
While challenges remain, the expanding array of treatment options offers new hope for PBC patients who don't respond to UDCA alone.
Curious about new PBC treatments? Discuss with Doctronic to learn more about current options and ongoing research in PBC therapy.Related Articles
References
Nevens F, et al. A Placebo-Controlled Trial of Obeticholic Acid in Primary Biliary Cholangitis. N Engl J Med 2016; 375:631.
Corpechot C, et al. A Placebo-Controlled Trial of Bezafibrate in Primary Biliary Cholangitis. N Engl J Med 2018; 378:2171.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.