What are the treatments for primary biliary cholangitis (PBC)?

There is no known cure for PBC. Doctors use medication to manage symptoms and slow the progression of PBC. Ursodiol (Actigall®) helps remove bile from the liver. This treatment improves liver function and prevents progression of the liver disease in many cases. Another drug, obeticholic acid (Ocaliva®) is used in combination with ursodeoxycholic acid (UDCA) or alone if UDCA is not effective or cannot be tolerated. This therapy reduces the amount of bile produced and increases the flow of bile out of the liver.

Other drug options are available depending on each patient’s unique situation and presence of other medical conditions. A liver transplant may be needed if liver function continues to worsen despite medical treatment.

To treat the common problem of intense itching, diphenhydramine (Benadryl®; available over-the-counter) or the prescription drugs hydroxyzine (Vistaril®) or cholestyramine (Locholest®, Questran®) may be prescribed.

What are common complications or side effects of primary biliary cholangitis (PBC)?

Some people with PBC develop osteoporosis (thinning of the bones), which can lead to bone breaks (bone fractures). This complication typically occurs when a person is in the later stages of the disease. Doctors often treat osteoporosis by recommending regular exercise and prescribing medicines such as alendronate (Fosamax®) or risedronic acid (Actonel®). Both of these treatments help strengthen bones.

Other complications include high cholesterol levels, fat soluble vitamin deficiency, and an increased risk of liver cancer.

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