Clinical, safety, and patient-reported outcomes associated with second-line and later therapies in primary biliary cholangitis: A systematic review.

What was studied

This review looked at studies of treatments for primary biliary cholangitis. The disease is rare and long-lasting. It covered people with no response to ursodeoxycholic acid, or poor tolerance. They needed later-line therapy. Databases were searched in 2025. The review included 149 publications on 44 unique studies.

What they found

Late-stage trials tested elafibranor, seladelpar, budenoside, bezafibrate and obeticholic acid. Blood markers were often measured. Normal cutoffs and response thresholds varied a lot. In placebo-controlled trials, response rates favored active treatment.

What it means for patients

The authors say the evidence base is extensive but mixed. Designs, groups and scales differ. This limits comparison across trials. They say the review helps put study results in context.

Why it is not certain yet

Comparison across trials is limited. Cutoffs varied between trials. Placebo responses varied a lot. Each trial used its own methods. The abstract gives no pooled treatment effects. A review can only be as good as the studies in it. New data may change the picture. The data come from other trials.

Source

Clinical, safety, and patient-reported outcomes associated with second-line and later therapies in primary biliary cholangitis: A systematic review.

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