New Study Gives Hope for Treatment of PBC

Before we get into the study that shows the possible treatment for silent liver disease, we need to tell you what the disease is. So if you are unaware of the disease, then let us brief you a little bit.

As you know that it is most commonly called Silent liver disease, but it has an official name. It is called Primary Biliary Cholangitis (PBC), which is an autoimmune disease. This is a disease where the small bile ducts are there of the liver, and then this becomes inflamed.

The disease is highly troublesome in the fact that it often goes undetected, and when a disease goes undetected, then it becomes more dangerous to the person.

As a person will not be aware of the problems that is going on in the body and with the passage of time, there is a potentially leading factor that can lead to scarring and cirrhosis of the liver, liver failure, and if that happens, then it can ultimately lead to possible death.

Patients are not well aware of the disease, and doctors have a hard time recognizing it until it is too late and the people who are in the advanced stages of the disease and who do not respond to other therapies require a liver transplant if they want to survive. There is no other way to do it.

The study that we are talking about is called the POISE long-term safety extension (LTSE) study. It was a study that was done with the analysis that compared 209 patients who are having the disease of PBC and those who have been treated with OCA for a maximum follow-up time of 6.3 years. The result seems to be promising.

The researchers have gone ahead with the study pattern, and they have found that the patients treated with OCA in one of the trial settings that they had conducted, having a 72% to 80% lower risk of death or liver transplant. The odds are in favor of the people. So that is some really good news that had been found.

“When compared to real-world patient outcome data, the results provide insights into OCA’s potential to improve transplant-free survival in patients with PBC,” Gideon Hirschfield said in a press conference. We are truly happy to hear such good news!

What Are the Goals of Treatment for PBC?

The primary goals of treatment for PBC are to:

1. Slow Disease Progression: Treatment aims to slow down the progression of liver damage, delaying or preventing the onset of cirrhosis and liver failure.
2. Manage Symptoms: Treatment helps alleviate symptoms such as fatigue, itching, and dry eyes or mouth, which are common in PBC.
3. Prevent Complications: By managing PBC effectively, the goal is to prevent complications such as portal hypertension, varices, and liver failure.
4. Improve Quality of Life: Treatment also focuses on enhancing the patient’s overall quality of life by addressing both physical and emotional aspects of living with PBC.

Can the Liver Repair Itself with PBC?

The liver has a remarkable ability to regenerate and repair itself, but this capacity can be limited in the context of chronic diseases like PBC:

1. Early Stages: In the early stages of PBC, the liver may be able to repair some of the damage caused by the disease, especially with effective treatment.
2. Advanced Stages: As PBC progresses, the liver’s ability to repair itself diminishes, particularly if significant fibrosis or cirrhosis has developed.
3. Treatment Impact: Medications like ursodeoxycholic acid (UDCA) and obeticholic acid (OCA) can help slow the progression of PBC and support liver function, potentially allowing the liver to maintain some degree of self-repair.

Can I Live a Full Life with PBC?

Yes, many people with PBC can live full and active lives, especially if the disease is diagnosed early and managed effectively:

1. Early Diagnosis: Early detection and treatment are crucial in maintaining liver function and preventing complications. Many individuals with PBC who receive proper treatment live long, fulfilling lives.
2. Ongoing Management: Regular monitoring, adherence to treatment, and lifestyle modifications are key to managing PBC and maintaining a high quality of life.
3. Support and Resources: Access to support groups, counseling, and patient education can help individuals cope with the emotional and physical challenges of PBC.

How Is Quality of Life with PBC?

Quality of life for individuals with PBC can vary depending on the stage of the disease and the effectiveness of treatment:

1. Symptom Management: Effective management of symptoms such as fatigue and itching can significantly improve quality of life.
2. Psychosocial Factors: Emotional and psychological support is important, as chronic conditions like PBC can impact mental health. Depression and anxiety are not uncommon, and addressing these issues can enhance overall well-being.
3. Physical Activity: Staying active and maintaining a healthy lifestyle can contribute to a better quality of life, even with PBC.
4. Long-Term Outlook: With advances in treatment, many people with PBC can maintain a good quality of life for many years, although regular monitoring and treatment adjustments are often necessary.

What Is End-Stage PBC?

End-stage PBC occurs when the disease has progressed to the point of significant liver damage, leading to cirrhosis and liver failure:

1. Symptoms: End-stage PBC is characterized by severe symptoms such as jaundice, ascites (fluid buildup in the abdomen), hepatic encephalopathy (confusion and cognitive decline), and severe fatigue.
2. Complications: At this stage, complications such as portal hypertension, varices, and liver cancer are more likely to occur.
3. Treatment Options: For individuals with end-stage PBC, liver transplantation may be the only option for long-term survival. Management focuses on controlling symptoms and preparing for potential transplantation.

What Supplements Help with PBC?

Certain supplements may help support liver health and manage symptoms of PBC, though it’s important to consult with a healthcare provider before starting any new supplements:

1. Vitamin D: People with PBC are often deficient in vitamin D, which is important for bone health. Supplementation can help maintain bone density and prevent osteoporosis.
2. Calcium: Calcium supplements, along with vitamin D, are often recommended to support bone health, especially in those at risk for osteoporosis.
3. Omega-3 Fatty Acids: These can help reduce inflammation and may benefit liver health. Omega-3s are found in fish oil and flaxseed oil supplements.
4. Milk Thistle: Some studies suggest that milk thistle may support liver function, although more research is needed to confirm its benefits in PBC.
5. Selenium: Selenium has antioxidant properties that may support liver health, though its role in PBC is not fully established.

Does PBC Return After Liver Transplant?

While liver transplantation is a treatment option for end-stage PBC, the disease can, in some cases, recur after the transplant:

1. Recurrence Rates: Studies suggest that PBC can recur in about 20-30% of patients after liver transplantation, though it typically progresses more slowly in the transplanted liver.
2. Monitoring: Regular follow-up and monitoring are essential after transplantation to detect any signs of recurrence early and manage them effectively.
3. Immunosuppression: Immunosuppressive medications, which are necessary to prevent organ rejection, may influence the recurrence of PBC. Adjusting these medications can sometimes help manage recurrence.

New Hope for Treatment of PBC

Recent studies have brought hope for new treatments that could further improve the management of PBC:

1. Farnesoid X Receptor (FXR) Agonists: These are a class of drugs that include obeticholic acid, which has been shown to reduce liver inflammation and slow disease progression in PBC patients who do not respond to UDCA.
2. Novel Therapies: Ongoing research is exploring other potential therapies, including drugs that target specific pathways involved in liver inflammation and fibrosis.
3. Combination Therapies: There is interest in using a combination of treatments to enhance effectiveness, particularly in patients who do not respond adequately to current therapies.

Frequently Asked Questions (FAQs) About PBC

1. Can Diet Affect PBC?

Yes, diet can play a role in managing PBC. A balanced diet that supports liver health, along with avoiding alcohol and managing cholesterol, can be beneficial. It’s important to consult with a healthcare provider for personalized dietary advice.

2. Is PBC Hereditary?

While the exact cause of PBC is not known, there is evidence to suggest a genetic predisposition. Family history can be a factor, although environmental and autoimmune factors also play significant roles.

3. How Is PBC Diagnosed?

PBC is typically diagnosed through a combination of blood tests, imaging studies, and liver biopsy. Blood tests often show elevated liver enzymes and the presence of antimitochondrial antibodies (AMA).

4. What Are the Early Signs of PBC?

Early signs of PBC may include fatigue, itching, and dry eyes or mouth. Many patients are asymptomatic in the early stages, and the disease is often discovered through routine blood tests.

5. Can PBC Be Cured?

Currently, there is no cure for PBC, but treatments can effectively manage the disease and improve quality of life. Research is ongoing to find more effective treatments and potentially a cure.

Conclusion

Primary Biliary Cholangitis is a chronic liver disease that can significantly impact a person’s life. However, with advancements in treatment and ongoing research, there is hope for improved management and outcomes for those living with PBC.

Early diagnosis, effective treatment, and a comprehensive approach to managing symptoms and complications can help individuals with PBC lead full and active lives.

Whether through lifestyle changes, medical treatments, or potential new therapies, there are many avenues to explore in the fight against PBC.