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Update in the Care and Management of Patients with Primary Sclerosing Cholangitis

Mai Sedki1, Cynthia Levy2

  • 1Department of Internal Medicine, University of Miami/Jackson Memorial Hospital, Miami, FL, USA.

Current Gastroenterology Reports
|June 11, 2018
PubMed
Abstract

Insights

Primary sclerosing cholangitis (PSC) lacks specific medical treatments. Research explores new drugs and endoscopic therapies, but liver transplantation remains the only survival-extending option for this progressive liver disease.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Internal Medicine

Background:

  • Primary sclerosing cholangitis (PSC) is a chronic, progressive cholestatic liver disease.
  • Currently, no specific medical therapies exist for PSC, with treatment focusing on complication management.

Purpose of the Study:

  • To review novel therapies under investigation for PSC.
  • To provide a foundation for surveillance strategies in PSC patients.

Main Methods:

  • Literature review of emerging drugs and endoscopic interventions for PSC.
  • Analysis of current treatment outcomes and recurrence rates post-transplantation.

Main Results:

  • Investigational drugs include norursodeoxycholic acid, nuclear receptor agonists, anti-fibrotics, antibiotics, and anti-inflammatory agents.
  • Endoscopic therapy is recommended for dominant strictures; stenting may increase complications compared to balloon dilatation.
  • Malignancies are a leading cause of PSC mortality, and PSC recurrence affects up to 35% of liver transplant recipients.

Conclusions:

  • Liver transplantation is the only current treatment to prolong survival in PSC.
  • Ongoing research into novel pharmacotherapies and improved endoscopic techniques is crucial.
  • Regular surveillance for malignancies and monitoring for PSC recurrence post-transplant are essential.
Keywords:
AntibioticsEndoscopyNovel therapiesPrimary sclerosing cholangitisSurveillanceUrsodeoxycholic acid

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