John Vierling, MD, FACP, FAASLD, AGAF

The panel of experts offers expert insights and concluding thoughts on the management of primary biliary cholangitis (PBC), emphasizing the importance of personalized treatment strategies, monitoring, and the evolving role of new therapies in improving patient outcomes.

The panel of experts addresses potential challenges in the adoption of peroxisome proliferator-activated receptor (PPAR) agonists for primary biliary cholangitis (PBC), including barriers to access, patient selection, and long-term treatment considerations.

The panel of experts discuss how to determine the effectiveness of treatment in primary biliary cholangitis (PBC), focusing on key clinical markers, biochemical responses, and patient outcomes.

The panel of experts explore the potential integration of peroxisome proliferator-activated receptor (PPAR) agonists into the current treatment landscape for primary biliary cholangitis (PBC) and provides recommendations for patients currently taking fibrates for managing the disease.

The panel of experts examine the long-term data for the recently FDA-approved PPAR-δ agonist elafibranor in the treatment of primary biliary cholangitis (PBC), comparing its clinical findings with those of seladelpar, and explores how to choose the right peroxisome proliferator-activated receptor (PPAR) agonist and assess treatment effectiveness.

The panel of experts discuss the role of effectively treating pruritus, a common and debilitating symptom in over 80% of patients with cholestatic liver diseases like primary biliary cholangitis (PBC), and its importance in the long-term management of the disease.

The panel of experts review the long-term data on the recently FDA-approved PPAR-δ agonist seladelpar for primary biliary cholangitis (PBC), focusing on its efficacy, safety, and impact on liver biochemistry markers over time.

The panel of experts explore the use of FDA-approved peroxisome proliferator-activated receptor (PPAR) agonists in the management of primary biliary cholangitis (PBC), discussing their scientific basis, how they differ from fibrates, and their role in combination with ursodeoxycholic acid (UDCA) or as monotherapy for UDCA-intolerant patients.

The panel of experts cover second-line treatment options for primary biliary cholangitis (PBC), focusing on the use of obeticholic acid (OCA), its mechanism of action, management of adverse effects like pruritus and fatigue, the role of off-label fibrates, and strategies for assessing and adjusting therapy based on patient response and adverse effects.

The panel of experts outline the primary treatment goals for patients with primary biliary cholangitis (PBC), detailing how goals adjust based on disease severity, the role of ursodeoxycholic acid (UDCA) as first-line therapy, and the challenges that may require therapy modifications based on biochemical response.

The panel of experts focus on strategies for distinguishing primary biliary cholangitis (PBC) from other liver diseases with similar clinical presentations, emphasizing key diagnostic markers and assessment techniques.

The panel of experts examine major complications and comorbidities associated with primary biliary cholangitis (PBC), including vitamin deficiencies, osteoporosis, and conditions like metabolic-associated steatohepatitis (MASH), autoimmune disorders, and obesity.

The panelists discuss the typical presentation of primary biliary cholangitis (PBC), covering common and uncommon symptoms, the diagnostic journey, and key clinical and laboratory assessments used to identify disease markers.

The panelists explain the pathophysiology of primary biliary cholangitis (PBC), highlighting how immune-mediated processes contribute to progressive liver damage in affected patients.