The American Gastroenterological Association (AGA) and the American Association for the Study of Liver Diseases (AASLD) have published joint clinical practice guidelines outlining six recommendations for diagnosing and managing primary biliary cholangitis (PBC). Developed by a multidisciplinary panel, the guidance focuses on earlier diagnosis, appropriate treatment selection, risk stratification, symptom management, and preventing disease recurrence after liver transplantation.
Key recommendations include testing for anti-sp100 and anti-gp210 antibodies in patients suspected of PBC who are negative for antimitochondrial antibodies; using ursodeoxycholic acid (UDCA) as first-line treatment; and incorporating liver stiffness measurements to assess prognosis. For patients who do not respond adequately to UDCA or cannot tolerate it, the guidelines recommend peroxisome proliferator-activated receptor (PPAR) agonists, including elafibranor and seladelpar, or fibrates such as bezafibrate and fenofibrate.