Primary biliary cholangitis: progress and gaps in diagnosis and treatment

Abstract

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease. In the 21st century, the management of ursodeoxycholic acid (UDCA)-refractory cases is the main highlight in the medical treatment of PBC. Although prescriptions, such as bezafibrate or obeticholic, are used to address refractoriness to UDCA, the development of next-generation drugs and the evaluation of the efficacy of a dual add-on therapy remain in progress, which aimed to eliminate occurrence of refractory response to add-on therapy. Other highlights include the diagnosis of anti-mitochondria antibody-negative PBC and PBC-autoimmune hepatitis overlap, prediction of treatment-response and prognosis, and management of patient-reported outcomes (pruritus). Herein, an overview of the progress and unmet needs in the diagnosis and treatment of PBC, focusing on personalized medicine, is hereby elucidated.