Learn more about primary biliary cholangitis and how it affects your health here.

1. Understanding PBC
Primary Biliary Cholangitis

2. What is primary
biliary cholangitis?
Primary biliary cholangitis (PBC)
is chronic liver disease resulting
from progressive destruction of
the intrahepatic bile ducts.
Bile produced in your liver travels
via these ducts to your small
intestine where it aids in the
digestion of fat and fat-soluble
vitamins (A, D, E and K).

3. How does PBC affect your health?
Destruction of the bile ducts causes bile to
accumulate in the liver, leading to inflammation
and scarring (fibrosis).
Bile accumulation leads to cirrhosis and its
associated complications.
Signs & Symptoms
• Fatigue
• Pruritus (Itching of the skin)
• Abdominal pain
• Darkening of the skin
• Small yellow or white bumps
under the skin or around the eyes
• Dry mouth and eyes
• Bone, muscle and joint pain

4. Symptoms of
Disease Progression
As the disease progresses, symptoms
of cirrhosis can develop including:
• Yellowing of the skin (jaundice)
• Swelling of the legs and feet (edema)
• Enlarged abdomen from fluid
accumulation (ascites)
• Internal bleeding in the upper
stomach and esophagus from
enlarged veins (varices)
• Thinning of the bones (osteoporosis)
leading to fractures is another
complication of PBC.

5. What causes PBC?
The cause is unknown. It may be related
to problems in the immune system.
Who is at risk for PBC?
• Women make up about 90%
of PBC cases
• People between the ages of
35 to 60 years
• Genetic component: it is
more common among
siblings and in families

6. PBC Diagnosis
PBC diagnoses are often discovered
incidentally due to abnormal results
from routine liver blood tests.
PBC may also be detected
through positive blood tests for
antimitochondrial antibody (AMA),
as well as during a liver biopsy.

7. PBC Treatment Options
There is no cure for PBC.
Medications like Ursodiol are
available to slow disease progression
and manage symptoms.
If used early enough, Ursodiol can
improve liver function and may keep
you from needing, or delay the need
for a liver transplant. People with
PBC must take this medication every
day for life.

8. Ursodiol (UCDA)
Treatment For PBC
• Effective in 50%-60%
of patients
• 40% of patients do not
achieve an adequate
reduction in ALP or
bilirubin
• 5-10% are unable to
tolerate UDCA
Obeticholic Acid
Treatment For PBC
In May 2016, obeticholic
acid (brand name Ocaliva)
was approved for the
treatment of PBC in
combination with UDCA in
adults with an inadequate
response to UDCA, or as
a single therapy in adults
unable to tolerate UDCA.

9. How does Obeticholic
Acid Treatment work?
• Increases bile flow from the
liver and suppresses bile acid
production in the liver
• Reduces the exposure of the
liver to toxic levels of bile acids
Side effects of obeticholic acid:
• Increased itching
• Elevations in blood lipids

10. Alternative Treatments
for PBC
• Fenofibrate
• Prednisone or Azathioprine
• For patients with the “overlap
syndrome” with autoimmune
hepatitis.
• When medical treatment no
longer sufficiently controls the
disease.
• Liver transplantation ( end stage
liver disease)

11. Treating the Symptoms
• Itchiness
• Over -the- counter antihistamines
like Benadryl
• Rifampicin, Naltrexone,
Cholestyramine, Sertraline
• Dry eyes
• Eye drops (artificial tears)
• Dry Mouth
• Hard candy
• Chewing gum

12. What lifestyle changes may be
helpful for PBC patients?
• Start a reduced sodium diet
• Reduce fat intake
• Drink plenty of water
• Avoid or lower intake of alcohol
• Avoid undue stress when possible
• Start exercising, particularly walking
• Stop smoking
• Maintain good skin care
• Get regular dental examinations

13. CUTTING-EDGE RESEARCH
FOR LIVER DISEASE
Contact us today to find out if you qualify
for one of our cutting-edge research studies.
San Antonio Office – 210.982.0320
Austin Office – 512.384.1560
info@pinnacleresearch.com
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