Cholestatic Liver Disease: Current Treatment Strategies and New Therapeutic Agents

Cholestatic liver disease is a disease that causes liver damage and fibrosis owing to bile stasis. It is represented by primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), but the pathophysiological pathways that cause bile stasis in both diseases are different. The pathogene...

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Bibliographic Details
Published in:Drugs (New York, N.Y.) N.Y.), 2021-07, Vol.81 (10), p.1181-1192
Main Authors: Hasegawa, Sho, Yoneda, Masato, Kurita, Yusuke, Nogami, Asako, Honda, Yasushi, Hosono, Kunihiro, Nakajima, Atsushi
Format: Article
Language:English
Subjects:
Acids
Asymptomatic
Bile
Bile ducts
Chemical compounds
Cholangitis
Cirrhosis
Clinical medicine
Clinical trials
Drug development
Drug dosages
Drug therapy
Fibrosis
Health services
Immunosuppressive agents
Internal Medicine
Liver
Liver cirrhosis
Liver diseases
Liver transplantation
Medical prognosis
Medical research
Medical treatment
Medicine
Medicine & Public Health
Natural history
Pathogenesis
Patients
Pharmacology
Pharmacology/Toxicology
Pharmacotherapy
R&D
Research & development
Review
Review Article
Transplantation
Ursodeoxycholic acid
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Summary:Cholestatic liver disease is a disease that causes liver damage and fibrosis owing to bile stasis. It is represented by primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), but the pathophysiological pathways that cause bile stasis in both diseases are different. The pathogenesis of the disease is still unclear, although autoimmune mechanisms have been postulated and partially elucidated. Although the disease may progress slowly with only mild liver dysfunction, it may progress to liver cirrhosis or liver failure, which require liver transplantation. As a medical treatment, ursodeoxycholic acid is widely used for PBC and has proved to be very effective against disease progression in cases of PBC. On the other hand, its efficacy is limited in cases of PSC, and the research and development of various drugs are underway. Furthermore, the clinical course of both diseases is quite variable, making the design of clinical trials fairly difficult. In this review, we present the general natural history of PBC and PSC, and provide information on the latest drug therapies currently available and those that are under investigation.
ISSN:0012-6667
1179-1950
DOI:10.1007/s40265-021-01545-7