Primary biliary cholangitis as a roadmap for the development of novel treatments for cholestatic liver diseases

The discovery of nuclear receptors and transporters has contributed to the development of new drugs for the treatment of cholestatic liver diseases. Particular progress has been made in the development of second-line therapies for PBC. These new drugs can be separated into compounds primarily targeting cholestasis, molecules targeting fibrogenesis and molecules with immune-mediated action. Finally, drugs aimed at symptom relief (pruritus and fatigue) are also under investigation. Obeticholic acid is currently the only approved second-line therapy for PBC. Drugs in the late phase of clinical development include peroxisome proliferator-activated receptor agonists, norursodeoxycholic acid and NADPH oxidase 1/4 inhibitors.(C) 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Automated summary

The discovery of nuclear receptors and transporters has contributed to the development of new drugs for the treatment of cholestatic liver diseases, particularly in the field of second-line therapies for PBC. These new drugs can target cholestasis, fibrogenesis, immune-mediated action, and symptom relief. Obeticholic acid is currently the only approved second-line therapy for PBC, while other drugs in late-stage clinical development include peroxisome proliferator-activated receptor agonists, norursodeoxycholic acid, and NADPH oxidase 1/4 inhibitors.