Obeticholic Acid for Primary Biliary Cholangitis
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Primary biliary cholangitis (PBC) is a rare autoimmune cholestatic liver disease that may progress to fibrosis and/or cirrhosis. Treatment options are currently limited. The first-line therapy for this disease is the drug ursodeoxycholic acid (UDCA), which has been proven to normalize serum markers of liver dysfunction, halt histologic disease progression, and lead to a prolongation of transplant-free survival. However, 30–40% of patients unfortunately do not respond to this first-line therapy. Obeticholic acid (OCA) is the only registered agent for second-line treatment in UDCA-non responders. In this review, we focus on the pharmacological features of OCA, describing its mechanism of action of and its tolerability and efficacy in PBC patients. We also highlight current perspectives on future therapies for this condition.
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AASLD emphasized that OCA is contraindicated in patients with decompensated cirrhosis and recommended close monitoring of all patients with cirrhosis receiving OCA.
“AASLD further emphasized that OCA is contraindicated in patients with decompensated cirrhosis and recommended close monitoring of all patients with cirrhosis receiving OCA, even those without advanced disease [18].”
From Second-Line Therapies in Primary Biliary Cholangitis: A Comparative Review of Obeticholic Acid, Fibrates, Seladelpar, and Elafibranor (2025) · cites this paper as [18]
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- Authors
- Floreani, A., Gabbia, D., & De Martin, S.
- Affiliations
- University of Padua (IT)
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
- Corresponding author
- Floreani, Annarosa
- Venue
- Biomedicines
- Publisher
- MDPI AG
- Published
- 2022-10-02
- Volume
- 10
- Issue
- 10
- Pages
- 2464
- ISSN
- 2227-9059 (ISSN-L)
- PMC
- PMC9599277
- OpenAlex
- W4303614203
- Cited by
- 41
- References
- 54
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 12 · 2023: 7
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Biomedicines (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Keywords
- obeticholic acid, primary biliary cirrhosis, ursodeoxycholic acid, second-line therapy, mechanism of action, drug tolerability, treatment efficacy, autoimmune cholestatic liver disease, fibrosis, liver cirrhosis, transplant-free survival
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