Update in the Care and Management of Patients with Primary Sclerosing Cholangitis

Mai Sedki, Cynthia Levy

Research output: Contribution to journalReview article

1 Citation (Scopus)

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 languageEnglish (US)
Article number29
JournalCurrent Gastroenterology Reports
Volume20
Issue number7
DOIs
StatePublished - Jul 1 2018

Fingerprint

Patient Care Management
Sclerosing Cholangitis
Therapeutics
Pharmaceutical Preparations
Neoplasms
Cytoplasmic and Nuclear Receptors
Liver Transplantation
Stents
Allografts
Liver Diseases
Dilatation
Pathologic Constriction
Anti-Inflammatory Agents
Anti-Bacterial Agents
Recurrence
Acids
Mortality

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 journalReview article

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