Abstract
Purpose of Review: Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease for which specific medical therapy is not available. The goals of treatment are primarily early detection and management of complications. In this review, we discuss novel therapies under evaluation and provide the foundation for surveillance strategies. Recent Findings: Drugs under investigation include norursodeoxycholic acid, nuclear receptor agonists, anti-fibrotics, antibiotics, and anti-inflammatory drugs. Endoscopic therapy is indicated for symptomatic dominant strictures and in the work-up of malignancies. Recently, the use of stents was associated with an increased rate of complications compared to balloon dilatation; and long-term stenting should be avoided. Malignancies currently account for most of the PSC-related mortality. Summary: Many drugs are emerging for the treatment of PSC but liver transplantation is the only treatment modality shown to prolong survival. PSC recurrence occurs in up to 35% of transplanted allografts within a median of 5 years. Surveillance for hepatobiliary and colorectal malignancies is indicated.
| Original language | English (US) |
|---|---|
| Article number | 29 |
| Journal | Current Gastroenterology Reports |
| Volume | 20 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2018 |
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Keywords
- Antibiotics
- Endoscopy
- Novel therapies
- Primary sclerosing cholangitis
- Surveillance
- Ursodeoxycholic acid
ASJC Scopus subject areas
- Gastroenterology
Cite this
Update in the Care and Management of Patients with Primary Sclerosing Cholangitis. / Sedki, Mai; Levy, Cynthia.
In: Current Gastroenterology Reports, Vol. 20, No. 7, 29, 01.07.2018.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Update in the Care and Management of Patients with Primary Sclerosing Cholangitis
AU - Sedki, Mai
AU - Levy, Cynthia
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Purpose of Review: Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease for which specific medical therapy is not available. The goals of treatment are primarily early detection and management of complications. In this review, we discuss novel therapies under evaluation and provide the foundation for surveillance strategies. Recent Findings: Drugs under investigation include norursodeoxycholic acid, nuclear receptor agonists, anti-fibrotics, antibiotics, and anti-inflammatory drugs. Endoscopic therapy is indicated for symptomatic dominant strictures and in the work-up of malignancies. Recently, the use of stents was associated with an increased rate of complications compared to balloon dilatation; and long-term stenting should be avoided. Malignancies currently account for most of the PSC-related mortality. Summary: Many drugs are emerging for the treatment of PSC but liver transplantation is the only treatment modality shown to prolong survival. PSC recurrence occurs in up to 35% of transplanted allografts within a median of 5 years. Surveillance for hepatobiliary and colorectal malignancies is indicated.
AB - Purpose of Review: Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease for which specific medical therapy is not available. The goals of treatment are primarily early detection and management of complications. In this review, we discuss novel therapies under evaluation and provide the foundation for surveillance strategies. Recent Findings: Drugs under investigation include norursodeoxycholic acid, nuclear receptor agonists, anti-fibrotics, antibiotics, and anti-inflammatory drugs. Endoscopic therapy is indicated for symptomatic dominant strictures and in the work-up of malignancies. Recently, the use of stents was associated with an increased rate of complications compared to balloon dilatation; and long-term stenting should be avoided. Malignancies currently account for most of the PSC-related mortality. Summary: Many drugs are emerging for the treatment of PSC but liver transplantation is the only treatment modality shown to prolong survival. PSC recurrence occurs in up to 35% of transplanted allografts within a median of 5 years. Surveillance for hepatobiliary and colorectal malignancies is indicated.
KW - Antibiotics
KW - Endoscopy
KW - Novel therapies
KW - Primary sclerosing cholangitis
KW - Surveillance
KW - Ursodeoxycholic acid
UR - http://www.scopus.com/inward/record.url?scp=85048511111&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048511111&partnerID=8YFLogxK
U2 - 10.1007/s11894-018-0635-8
DO - 10.1007/s11894-018-0635-8
M3 - Review article
C2 - 29886518
AN - SCOPUS:85048511111
VL - 20
JO - Current Gastroenterology Reports
JF - Current Gastroenterology Reports
SN - 1522-8037
IS - 7
M1 - 29
ER -