Treatment of Primary Sclerosing Cholangitis Including Transplantation

Clin Liver Dis. 2024 Feb;28(1):171-182. doi: 10.1016/j.cld.2023.07.008. Epub 2023 Aug 17.

Abstract

Primary sclerosing cholangitis is a progressive cholestatic liver disease that causes stricturing of the intra and extrahepatic bile ducts that can lead to cirrhosis and end stage liver disease. Effective medical therapy has been elusive, but a course of ursodeoxycholic acid may be prescribed at doses of 17-23 mg/kg/day for up to a year to determine if a reduction in serum alkaline phosphatase is observed. A number of drugs are under investigation, including FXR agonists with choleretic and antimicrobial properties. Liver transplantation for PSC has one of the highest survival rates, but recurrent PSC is seen in up to 25% of recipients.

Keywords: Cholestatic; Investigational; Liver; Therapy; Ursodeoxycholic acid.

Publication types

  • Review

MeSH terms

  • Cholagogues and Choleretics / therapeutic use
  • Cholangitis, Sclerosing* / drug therapy
  • Humans
  • Liver Cirrhosis
  • Liver Transplantation*
  • Ursodeoxycholic Acid / therapeutic use

Substances

  • Ursodeoxycholic Acid
  • Cholagogues and Choleretics