Primary sclerosing cholangitis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Overview

Liver transplantation is the gold standard for treatment of primary sclerosing cholangitis and there is no effective medical treatment. Ursodeoxycholic acid has been studied as a treatment for the disease. However, there is no proof for its benefit and the American College of Gastroenterology does not support its use in patients with primary sclerosing cholangitis.

Medical Therapy

Liver transplantation is the gold standard for treatment of primary sclerosing cholangitis and there is no effective medical treatment.
Ursodeoxycholic acid (UDCA) in the dose of 10-15 mg/kg/day has been studied as a treatment for the disease.
- However, there is no proof for the use of ursodeoxycholic acid in patients with primary sclerosing cholangitis.^[1]
  - The American College of Gastroenterology, 2015 guidelines does not support the use of ursodeoxycholic acid in patients with primary sclerosing cholangitis.^[2]^[3]^[4]
  - The American Association for the Study of Liver Diseases, 2010 guidelines recommends against the use of ursodeoxycholic acid in the treatment of primary sclerosing cholangitis.
Associated medical conditions and manifestations of end stage liver disease (ESLD) can be targeted by medical therapy and/or surgery.

References

↑ Angulo P, Lindor KD (1999). “Primary biliary cirrhosis and primary sclerosing cholangitis”. Clin Liver Dis. 3 (3): 529–70. PMID 11291238.
↑ Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ (2010). “Diagnosis and management of primary sclerosing cholangitis”. Hepatology. 51 (2): 660–78. doi:10.1002/hep.23294. PMID 20101749.
↑ “EASL Clinical Practice Guidelines: management of cholestatic liver diseases”. J. Hepatol. 51 (2): 237–67. 2009. doi:10.1016/j.jhep.2009.04.009. PMID 19501929.
↑ Lindor KD, Kowdley KV, Harrison ME (2015). “ACG Clinical Guideline: Primary Sclerosing Cholangitis”. Am. J. Gastroenterol. 110 (5): 646–59, quiz 660. doi:10.1038/ajg.2015.112. PMID 25869391.

Template:WikiDoc Sources

[pmid11291238-1] Angulo P, Lindor KD (1999). “Primary biliary cirrhosis and primary sclerosing cholangitis”. Clin Liver Dis. 3 (3): 529–70. PMID 11291238.

[pmid20101749-2] Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ (2010). “Diagnosis and management of primary sclerosing cholangitis”. Hepatology. 51 (2): 660–78. doi:10.1002/hep.23294. PMID 20101749.

[pmid19501929-3] “EASL Clinical Practice Guidelines: management of cholestatic liver diseases”. J. Hepatol. 51 (2): 237–67. 2009. doi:10.1016/j.jhep.2009.04.009. PMID 19501929.

[pmid25869391-4] Lindor KD, Kowdley KV, Harrison ME (2015). “ACG Clinical Guideline: Primary Sclerosing Cholangitis”. Am. J. Gastroenterol. 110 (5): 646–59, quiz 660. doi:10.1038/ajg.2015.112. PMID 25869391.

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