Primary Biliary Cirrhosis - Management A. Initiate therapy - Initiate 1st line therapy with UDCA (13-15 mg/kg PO daily). - Risk stratify patients on UDCA using biochemical and/or prognostic criteria as below. - Consider 2nd line therapy if ALP > 1.5x ULN and/or abnormal conjugated bilirubin despite 12 months on UDCA B. Manage symptoms - Pruritus: Cholestyramine, rifampicin, naltrexone, gabapentin, sertraline, bezafibrate - Fatigue: Non-pharmacological management - Sicca complex: Artificial tears and saliva, lubricants, and non-pharmacological management - Osteopenia/osteoporosis: Screen as per standard of care; routine calcium and vitamin D; consider therapy as indicated individually C. Risk stratify D. Stage & survey disease #PBC #Primary #Biliary #Cirrhosis #Management #Treatment #hepatology
