| [ Summary ] |
Since ursodeoxycholic acid (UDCA) has been regarded as an established first line treatment option for primary biliary cholangitis (PBC) in 1990s, a majority of PBC cases have been treated with UDCA and have exhibited acceptable responses. However, 30‒40 % of treated cases demonstrated limited treatment responses, and the prognoses of those cases were poorer than responders. Several response criteria have been developed and revealed a favorable prognosis in UDCA‒treatment responders. In recent years, the second line treatment option has been investigated. Among them, obeticholic acid (OCA) has been approved after the successful results in POISE trial. Also, other drugs, such as bezafibrate have been investigated in clinical trials. However, due to the prolonged natural history of PBC, novel drug development is not easy for PBC as in other human cholestatic liver diseases. |