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First drug-focused guideline outlines newer treatments for primary biliary cholangitis

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First drug-focused guideline outlines newer treatments for primary biliary cholangitis

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For the first time, a joint guideline from the American Gastroenterological Association (AGA) and American Association for the Study of Liver Diseases (AASLD) evaluates newer medications for primary biliary cholangitis (PBC), the most common cholestatic disease in adults. Published in Gastroenterology and HEPATOLOGY, the guideline provides evidence-based recommendations for diagnosis and treatment.

The guideline addresses recent changes in the PBC treatment landscape and key challenges clinicians face, including diagnosing patients with less common antibody profiles, determining when to move beyond first-line therapy and managing PBC-related itching. Because most people living with PBC are cared for by general gastroenterologists rather than hepatology specialists, the guideline is designed to ensure the broader GI community has access to the latest evidence and standards of care.

"The PBC treatment landscape has changed significantly in the past five years, with new options for second-line therapy and the removal of a treatment that had been used for the past decade," said guideline author David N. Assis, M.D.

"This guideline provides clinicians and patients with practical, evidence-based guidance on navigating challenging diagnoses and selecting appropriate second-line therapies as today's treatment options continue to evolve."

This guideline complements AASLD's broader 2018 and 2021 PBC guidance, which addressed PBC care more comprehensively, with special emphasis on second-line treatment options. S. market late in 2025.



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