期刊
ANNUAL REVIEW OF PHARMACOLOGY AND TOXICOLOGY, VOL 60
卷 60, 期 -, 页码 503-527出版社
ANNUAL REVIEWS
DOI: 10.1146/annurev-pharmtox-010818-021059
关键词
primary biliary cholangitis; primary sclerosing cholangitis; ursodeoxycholic acid; obeticholic acid
Though ursodeoxycholic acid (UDCA) remains the baseline treatment for most cholestatic liver diseases, UDCA treatment leaves approximately one-third of patients with primary biliary cholangitis (PBC) and all patients with primary sclerosing cholangitis (PSC) at risk for disease progression. New anticholestatic agents, including nuclear receptor agonists, choleretics, and bile acid synthesis suppressors, will likely increase response rates to therapy in PBC and PSC. Strategies that target early immune -mediated injury have so far been disappointing, hampered by the lack of biomarkers to detect early disease states, which then could profit from immunomodulatory therapy. Future concepts need to personalize treatments according to disease stage, progression, and phase, and to combine multiple drugs to target different pathogenic pathways.
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