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- PBC facts
- What treatments are used in patients with PBC?
- Ursodeoxycholic acid (UDCA)
- Colchicine (Colcrys)
- Immunosuppressive medications
- Budesonide (Entocort)
- Azathioprine (Imuran)
- Cyclosporine (Sandimmune, Neoral, Gengraf)
- Methotrexate (Rheumatrex, Trexall)
- Obeticolic acid (Ocaliva)
- Cholestyramine (Questran) for itching
- Rifampin for itching
- Opiod antagonists for itching
- Charcoal hemoperfusion for itching
- Osteoporosis medications
- Treatment of elevated serum cholesterol and xanthomas
- Treatment of malabsorption of fat and fat-soluble vitamins (A, D, E and K)
- Treatment of edema and ascites
- Treatment of bleeding from varices
- Treatment of hepatic encephalopathy
- Treatment of enlarged spleen
- Treatment of Sicca syndrome
- Treatment of Raynaud's phenomenon
- Treatment of scleroderma
- Treatment of gallstones
- Which specialties of doctors treat PBC?
- What is the role of liver transplantation in PBC?
- What is the future for PBC?
Colchicine, a drug that reduces inflammation and scarring, has been used primarily to treat arthritis caused by gout. Three randomized, controlled trials in PBC showed that colchicine, compared to placebo, modestly slowed progression of abnormal blood tests, but did not reduce symptoms or prevent progression of liver pathology (tissue abnormalities on the biopsy). One of the trials actually suggested that colchicine improved survival. This impression of better survival with colchicine, however, has not been substantiated. In fact, the seemingly improved survival appears to be due to an unexpectedly high death rate (mortality) among the patients receiving the inactive drug in that study. The benefits of colchicine are so small that it is rarely recommended.
Immunosuppressive medications, for example, corticosteroids, azathioprine, cyclosporine (Sandimmune, Neoral, Gengraf), and methotrexate (Rheumatrex, Trexall) suppress immune reactions. These medications are theoretically attractive agents to treat PBC, based on the concept that it is an autoimmune disease. Several randomized controlled studies have tested immunosuppressive drugs in PBC. However, none of these studies has demonstrated prolonged survival of patients.