New developments in the treatment of primary biliary cholangitis - role of obeticholic acid.
New developments in the treatment of primary biliary cholangitis - role of obeticholic acid.
复制标题
治疗原发性胆管炎的新发展 - ob乙酸的作用。
DOI：
10.2147/tcrm.s113052
复制
发表时间：
2017
影响因子：
2.8
通讯作者：
Kowdley KV
中科院分区：
文献类型：
--
作者：
Jhaveri MA;Kowdley KV
原发性胆汁性胆管炎（PBC）是一种慢性自身免疫性胆汁淤积性肝病，主要影响早期至中年妇女。它通常与线粒体抗原的自身抗体相关，导致免疫介导的中小型肝内胆管破坏，导致胆汁淤积、肝纤维化，并可能进展为肝硬化或肝衰竭，在某些情况下，肝细胞癌。多年来，由于认识到熊去氧胆酸（UDCA）的早期广泛使用，PBC的临床表现和自然史有所改善;约三分之一的患者对UDCA表现出次优生化反应，预后不良。直到最近，UDCA是二十多年来唯一一种美国食品和药物管理局批准用于这种疾病的药物;奥贝胆酸于2016年被批准用于治疗对UDCA反应不佳或不耐受的PBC患者。目前，肝移植是治疗PBC终末期肝病最有效的方法。本文就近年来奥贝胆酸治疗原发性胆管炎的研究进展作一综述。
Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease that predominantly affects women in early to middle age. It is typically associated with autoantibodies to mitochondrial antigens and results in immune-mediated destruction of small and medium-sized intrahepatic bile ducts leading to cholestasis, hepatic fibrosis and may progress to cirrhosis or hepatic failure and, in some cases, hepatocellular carcinoma. The clinical presentation and the natural history of PBC have improved over the years due to recognition of earlier widespread use of ursodeoxycholic acid (UDCA); about one-third of patients show suboptimal biochemical response to UDCA with poor prognosis. Until recently, UDCA was the only US Food and Drug Administration approved agent for this disease for more than two decades; obeticholic acid was approved in 2016 for treatment of patients with PBC with a suboptimal response or intolerance to UDCA. Currently, liver transplantation is the most effective treatment modality for PBC patients with end-stage liver disease. This review will focus on the recent advances in therapy of primary biliary cholangitis, with emphasis on obeticholic acid.