Primary biliary cholangitis is a chronic liver disease where the immune system attacks the bile ducts. It affects about 1 in 1,000 women, mostly diagnosed in their 50s and 60s. Ursodeoxycholic acid slows disease progression in many people, and obeticholic acid offers a second option, but some patients still progress to cirrhosis and need liver transplant.
What's actually going on in research
Trials are testing PPAR agonists that work through different pathways than current drugs, drugs targeting the inflammation and scarring process, and treatments for the severe itching that affects many patients. Researchers are also studying combination therapies and trying to identify which patients will respond to which treatments based on early markers.
PPAR agonists
These drugs activate receptors that control fat and bile metabolism. Seladelpar is being studied in people who don't respond adequately to ursodeoxycholic acid.
Anti-fibrotic therapies
Several drugs aim to slow or reverse liver scarring rather than just reducing bile duct damage. This could help people already showing signs of advanced disease.
Itch treatments
Severe itching can be debilitating in PBC, and current treatments often fall short. New drugs targeting specific itch pathways are showing promise in reducing this symptom.
What to know before you search
Eligibility typically depends on whether you've tried ursodeoxycholic acid, your liver function test results, presence of cirrhosis, and specific symptom severity like itch.
What types of trials are currently open
- Treatment trials — Testing new medications, often PPAR agonists or anti-inflammatory drugs, to see if they improve liver function markers better than current options.
- Combination trials — Testing whether adding a second drug to ursodeoxycholic acid works better than either drug alone.
- Symptom trials — Testing treatments specifically for itching, fatigue, or other symptoms that impact quality of life.
- Biomarker studies — Following patients to identify blood or imaging markers that predict who will progress and who will respond to specific treatments.
Recently added Primary Biliary Cholangitis trials
Take a combination of two experimental drugs for bile duct disease
The goal of this clinical study is to learn more about the combination of study drugs seladelpar and cilofexor. The study will assess, the safety, tolerability, and effectiveness of the combination drugs versus both seladelpar alone and placebo, in participants with primary biliary cholangitis (PBC). The primary objective of this study is to determine whether the combination of seladelpar + cilofexor leads to greater alkaline phosphatase (ALP) reduction than seladelpar alone and describe the safety and tolerability of seladelpar + cilofexor.
Receive a biodegradable stent to treat bile duct narrowing
In patients with PSC, endoscopic therapy of strictures aims to improve cholestasis by relieving the biliary obstruction via endoscopic biliary dilatation with consideration of plastic stents in strictures refractory to dilatation due to the risk of pancreatitis and cholangitis . Short term stents have been shown to have similar recurrence-free rates compared to dilatation in a randomised control trial; however, this was terminated after interim analysis due to higher rates of serious adverse events in the stent group. The long term benefits are unclear; however, it may lead to improved survival compared to predicted survival. In this group of patients with limited treatment options, biodegradable stents may provide an attractive additional treatment modality in the management of high grade strictures.
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