Impacting Disease Outcomes and Quality of Life in PBC: Individualizing Treatment Selection and the Role of Novel Therapies

Don't Forget, There's a Sleepy Patient Behind Those Numbers

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  • Overview

    Primary biliary cholangitis (PBC) is a chronic cholestatic autoimmune liver disease characterized by a destructive, small duct, and lymphocytic cholangitis, and marked by the presence of antimitochondrial antibodies. Outcomes largely depend on early recognition of the disease and prompt institution of treatment. First-line treatment consists of ursodeoxycholic acid, but not all patients sufficiently respond to treatment. It is thus important to monitor patients for response to therapy to know when to initiate second-line treatment. The recent approval of PPAR agonists has greatly improved second-line treatment options, as these therapies not only elicited significantly better biochemical responses and normalized bilirubin levels but also improved extrahepatic symptoms including pruritus and fatigue, leading to better quality of life.   

  • Disclosure of Relevant Financial Relationships

    In accordance with the ACCME Standards for Integrity and Independence, Global Learning Collaborative (GLC) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any ineligible company. GLC mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. 

    Host:

    Gideon Hirschfield, MB, BChir, PhD
    Director of the Autoimmune Liver Disease Program
    Toronto Centre for Liver Disease, Division of Gastroenterology and Hepatology
    Toronto General Hospital
    Toronto, CA

    Dr. Hirschfield has reported the following relevant financial relationships or relationships with ineligible companies of any amount during the past 24 months:
    Consulting Fees: GSK, Intercept, Advanz, Gilead, CymaBay, Ipsen, Kowa, Pliant, Mirum, and Escient.   

    Faculty:

    Kris V. Kowdley, MD 
    Director, Liver Institute Northwest
    Professor, Elson S. Floyd College of Medicine
    Washington State University
    Seattle, WA

    Dr. Kowdley has reported the following relevant financial relationships or relationships with ineligible companies of any amount during the past 24 months:
    Research: Akero, Astra Zeneca, Boston, Boehringer Ingelheim, Corcept, Gilead, GSK, Hanmi, Intercept, Inventiva, Janssen, Madrigal, Mirum, Novo Nordish, NGM, Pfizer, Pliant, Terns, Viking, 89bio, Zydus
    Stock Options: Inipharm
    : AbbVie, Gilead, Intercept, Ipsen
    Consulting Fees: Arbormed, Boehringer Ingelheim CymaBay, Genfit, Gilead, GSK, HighTide, Inipharm, Intercept, Ipsen, Madrigal, Mirum, NGM, Novo Nordisk, Orphalan, Pfizer, 89bio, Zydus

    Elizabeth K. Goacher, PA-C
    Director, PDC Advanced Practice Office
    Division of Gastroenterology
    Department of Medicine, Duke Health
    Durham, NC

    Ms. Goacher has reported the following relevant financial relationships or relationships with ineligible companies of any amount during the past 24 months:
    Consulting Fees: CymaBay, Gilead, GSK, Ipsen, Madrigal, and Salix

    Reviewers/Content Planners/Authors:

    • Cindy Davidson has nothing to disclose.
    • Wilma Guerra has nothing to disclose.
    • Brian P. McDonough, MD, FAAFP, has nothing to disclose.
  • Learning Objectives

    After participating in this educational activity, participants should be better able to:

    • Assess pretreatment primary biliary cholangitis (PBC) disease stage to determine risk of disease progression
    • Determine when to begin second-line therapy in a patient being treated with first-line therapy for PBC
    • Demonstrate how to assess severity of symptoms in patients with PBC
    • Interpret data from clinical trials of agents being investigated for the treatment of PBC
  • Target Audience

    This activity is designed to meet the continuing medical education needs of hepatologists, gastroenterologists, APPs, and other clinicians who manage patients with PBC.

  • Accreditation and Credit Designation Statements

    In support of improving patient care, Global Learning Collaborative (GLC) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

    Global Learning Collaborative (GLC) designates this MinuteCE  activity for a maximum of 1 credit  AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Global Learning Collaborative (GLC) designates this activity for 1 credit nursing contact hours. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

    Global Learning Collaborative (GLC) has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1 credit AAPA Category 1 CME credits. Approval is valid until 11/8/2025. PAs should claim only the credit commensurate with the extent of their participation in the activity.  

  • Provider(s)/Educational Partner(s)

    Prova Education designs and executes continuing education founded on evidence-based medicine, clinical need, gap analysis, learner feedback, and more. Our mission is to serve as an inventive and relevant resource for clinical content and educational interventions across a broad spectrum of specialties. 

    Prova Education's methodology demonstrates a commitment to continuing medical education and the innovative assessment of its effects. Our goal is clear—to develop and deliver the best education in the most impactful manner and to verify its results with progressive outcomes research.  

  • Commercial Support

    This activity is supported by an independent educational grant from Gilead Sciences, Inc.

  • Disclaimer

    The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of GLC and Prova. This presentation is not intended to define an exclusive course of patient management; the participant should use his/her clinical judgment, knowledge, experience, and diagnostic skills in applying or adopting for professional use any of the information provided herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Links to other sites may be provided as additional sources of information. Once you elect to access a site outside of Prova you are subject to the terms and conditions of use, including copyright and licensing restriction, of that site.

    Reproduction Prohibited
    Reproduction of this material is not permitted without written permission from the copyright owner.

  • System Requirements

    • Supported Browsers (2 most recent versions):
      • Google Chrome for Windows, Mac OS, iOS, and Android
      • Apple Safari for Mac OS and iOS
      • Mozilla Firefox for Windows, Mac OS, iOS, and Android
      • Microsoft Edge for Windows
    • Recommended Internet Speed: 5Mbps+

  • Publication Dates

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