Emerging drugs for the treatment of primary biliary cholangitis

Expert Opin Emerg Drugs. 2020 Jun;25(2):101-112. doi: 10.1080/14728214.2020.1751814. Epub 2020 May 5.

Abstract

Introduction: Primary biliary cholangitis (PBC) is a progressive inflammatory autoimmune cholestatic liver disease. Without treatment, it may result in fibrosis and eventually end stage liver disease. In addition to the disease burden, the symptom impact on the quality of life for PBC patients is significant. Ursodeoxycholic acid, and the second-line therapy, Obeticholic acid, are the only available licensed treatments. Although there has been rapid development of novel therapies in recent years for the treatment of PBC, there are very few symptoms directed therapies.

Area covered: This literature review aims to review the current treatment landscape in PBC and to explore how the next few years may unfold in the field. The current guidelines and emerging therapies in phase 2, 3 and 4 clinical trials have been included.

Expert opinion: The currently available therapies are effective, but their use has limitations and challenges and there is still significant unmet need. Although there have been promising therapeutic interventions in recent years, further research into personalizing therapeutic strategies with available treatments and new agents is needed.

Keywords: Primary biliary cholangitis; fatigue; nuclear receptor; senescence; therapies; pruritus.

Publication types

  • Review

MeSH terms

  • Animals
  • Chenodeoxycholic Acid / analogs & derivatives
  • Chenodeoxycholic Acid / therapeutic use
  • Cholagogues and Choleretics / therapeutic use
  • Disease Progression
  • Drug Development*
  • Humans
  • Liver Cirrhosis, Biliary / drug therapy*
  • Liver Cirrhosis, Biliary / physiopathology
  • Quality of Life*
  • Ursodeoxycholic Acid / therapeutic use

Substances

  • Cholagogues and Choleretics
  • obeticholic acid
  • Chenodeoxycholic Acid
  • Ursodeoxycholic Acid