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In this engaging update from the Allied Digestive Health Annual Conference, Dr. Sonal Kumar, hepatologist at Weill Cornell Medicine, shares the latest advancements in diagnosing and managing Primary Biliary Cholangitis (PBC). Dr. Kumar emphasizes the importance of early assessment and intervention—highlighting the limitations of outdated treatment algorithms that delay evaluation for second-line therapy. Instead, clinicians are now encouraged to assess patients as early as 6 months after starting ursodeoxycholic acid (UDCA), especially those with elevated alkaline phosphatase (ALP), advanced fibrosis, or younger age. The discussion also explores the evolving treatment goals in PBC, including a shift toward normalization of ALP and bilirubin levels as key biomarkers of disease activity and prognosis. Dr. Kumar highlights exciting data from the ELATIVE and RESPONSE trials, which led to the approval of two new PPAR agonists—elafibranor and seladelpar—offering improved ALP normalization rates and even symptom relief for pruritus. This marks a significant turning point in how hepatologists approach symptom management in PBC, with fatigue and pruritus now recognized as critical components of care. Learn more about this evolving treatment landscape and how these advancements are shaping a more personalized, proactive approach for patients living with PBC.

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In this comprehensive discussion, Hetal Karsan, Chair of Medical Education at United Digestive, explores how to manage complications of Primary Biliary Cholangitis (PBC) and their impact on patient quality of life. PBC is a chronic autoimmune cholestatic liver disease that primarily affects women—but is increasingly diagnosed in men. Dr. Karsan breaks down the progression from inflammation to fibrosis and cirrhosis, and emphasizes how early diagnosis and adherence to treatment with ursodeoxycholic acid (UDCA) can dramatically improve outcomes.

Learn practical strategies to monitor liver function, prevent and manage complications such as variceal hemorrhage, ascites, hepatic carcinoma, and osteoporosis. Discover the importance of normalizing alkaline phosphatase and bilirubin, supporting nutrition and vitamin levels, and reducing risk through lifestyle changes. Dr. Karsan also highlights how fatigue and pruritus impact daily life for patients with PBC and discusses both pharmacologic and non-pharmacologic ways to help. From screening recommendations to emotional support and patient education, this video is a vital guide for healthcare providers treating PBC.

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Discover the evolving landscape of Primary Biliary Cholangitis (PBC) treatment with Dr. Huiming Sooki Hon from United Digestive. In this expert-led discussion, Dr. Sooki Hon reviews both established and emerging therapies for PBC, beginning with first-line treatment using ursodeoxycholic acid (UDCA) and the importance of early diagnosis and biochemical monitoring. Learn why normalization—not just reduction—of alkaline phosphatase is becoming a new treatment goal, and why up to 40% of patients may require second-line therapy. Dr. Sooki Hon outlines the latest FDA-approved options, including obeticholic acid, elafibranor, and seladelpar, highlighting their mechanisms of action, efficacy, and key safety considerations. This video also explores promising investigational therapies and combination strategies aimed at slowing disease progression and improving symptom control. Whether you're a healthcare professional or a patient seeking updated information on PBC management, this comprehensive overview provides valuable insights into current standards and future directions.

In this expert spotlight, Dr. Nancy Reau of RUSH University Medical Center addresses two of the most pressing challenges in the management of Primary Biliary Cholangitis (PBC): delayed diagnosis and delayed treatment escalation. Drawing from clinical insights and institutional data, Dr. Reau discusses how symptoms such as fatigue, pruritus, and elevated alkaline phosphatase often go unrecognized for years—resulting in delayed initiation of therapy. She highlights the importance of earlier testing with antimitochondrial and PBC-specific antinuclear antibodies to improve time to diagnosis. Dr. Reau also examines the hesitancy among clinicians to escalate therapy beyond ursodeoxycholic acid (UDCA), despite new FDA-approved second-line treatments such as obeticholic acid and PPAR agonists. With clear benchmarks like alkaline phosphatase normalization and bilirubin control now guiding treatment response, she calls for timely intervention to improve prognosis, transplant-free survival, and quality of life in patients with PBC.

In this expert-led video, Dr. Nadege Gunn, a gastroenterologist and hepatologist based in Waco, Texas, offers a practical and up-to-date overview of primary biliary cholangitis (PBC)—a chronic autoimmune liver disease that primarily affects women and can progress to cirrhosis if not treated early. Dr. Gunn breaks down the key steps in diagnosing PBC using simple blood tests, including alkaline phosphatase and antimitochondrial antibody levels, and highlights the importance of non-invasive fibrosis assessment tools like elastography. She discusses first-line treatment with ursodeoxycholic acid (UDCA) and reviews second-line therapies such as obeticholic acid and newer agents with PPAR mechanisms that are emerging in 2024 to address both biochemical response and symptom control, including pruritus. With a focus on early diagnosis, personalized care, and integrating evolving therapies, Dr. Gunn emphasizes the need to proactively manage PBC to prevent progression and improve long-term outcomes. This video is a must-watch for healthcare professionals seeking a concise yet comprehensive clinical approach to PBC.

In this video, Dr. Sonal Kumar, hepatologist at Weill Cornell Medical College in New York City, discusses the complex and often debilitating symptoms associated with Primary Biliary Cholangitis (PBC)—a chronic autoimmune liver disease. Dr. Kumar provides expert insight into symptom identification and management strategies for pruritus (itching), fatigue, jaundice, dry eyes and mouth (Sjögren's overlap), and brain fog. She emphasizes that symptom burden in PBC does not always align with disease severity, meaning even patients with early-stage or well-controlled liver disease may experience significant quality-of-life disruptions. The video explores first-line and second-line treatments for pruritus, techniques to manage fatigue, and supportive therapies for brain fog and dryness. Dr. Kumar also highlights the importance of multidisciplinary care and addressing coexisting mental health concerns to optimize outcomes. For healthcare providers managing patients with PBC, this presentation reinforces the need for a personalized, symptom-focused approach to care.

In this expert-led video, Dr. Jeff Kahn, hepatologist at the University of Southern California, explores the often-overlooked topic of symptom control and quality of life in primary biliary cholangitis (PBC). Although PBC is a chronic liver disease, symptoms like fatigue and pruritus (itching) can appear early and significantly impact patients’ daily functioning, mental health, and sleep—often independent of liver disease severity. Dr. Kahn offers practical strategies for managing these symptoms, including first-line and second-line treatments for itching, approaches to improving sleep hygiene, and the importance of addressing vitamin deficiencies (A, D, and K) to reduce the risk of osteoporosis. He also highlights the role of advanced practice providers (APPs) in building trust with patients and navigating sensitive topics. The video closes with a discussion on when to consider liver transplantation and how long-term outcomes for patients with PBC are often favorable. For more insights and resources, visit GHAPP.org or download the GHAPP ACE App.

In this episode, Marcelo Kugelmas, MD, and Steven Flamm, MD, discuss strategies to prevent clinical decompensation in patients with cirrhosis and clinically significant portal hypertension. They explore the importance of identifying overlapping liver disease etiologies—such as MASLD/metALD and alcohol-related liver disease—and emphasize a thorough diagnostic approach using non-invasive fibrosis staging tools like transient elastography, ELF, FibroSure, and Fib-4. The conversation highlights the role of liver stiffness measurements and platelet count in diagnosing clinically significant portal hypertension, referencing the latest AASLD guidelines and the “Rule of Fives.” The speakers also review the use of carvedilol as a first-line non-selective beta blocker to reduce the risk of variceal bleeding and improve survival—even in the absence of large varices. They offer clinical insights on when endoscopic variceal banding may still be appropriate and how evolving practices are shaping the future of portal hypertension management. This episode is a must-listen for hepatologists, gastroenterologists, and providers managing patients with advanced chronic liver disease.

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Join Dr. Steven Flamm, Rush University Medical School, and Dr. Naim Alkhouri, Arizona Liver Health, for an in-depth discussion on Resmetirom — the first FDA-approved treatment for adults with MASH (Metabolic Dysfunction-Associated Steatohepatitis) and moderate to advanced fibrosis. In this expert-led podcast, the panel explores the groundbreaking clinical data behind Resmetirom, including findings from the MAESTRO-NASH trial, which demonstrated fibrosis regression and NASH resolution after just one year of treatment. Drs. Flamm and Alkhouri review real-world patient experiences, optimal use of non-invasive tests (like FibroScan, ELF, and MRI-PDFF), practical monitoring strategies, and common questions on dosing, side effects, and access.

This conversation also addresses treatment selection, synergistic use of Resmetirom with GLP-1 receptor agonists, and how to approach medication continuation or discontinuation in responders. For liver care providers managing patients with MASLD and MASH, this podcast offers valuable guidance on how to incorporate this landmark therapy into practice.

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Dr. Reed Hogan, a practicing gastroenterologist in Jackson, Mississippi, shares his clinical experience and insights on Resmetirom, the first FDA-approved therapy for MASH (Metabolic Dysfunction-Associated Steatohepatitis). With over 6,000 patients screened annually in his metabolic and fatty liver clinics, Dr. Hogan highlights the urgent need for effective treatment options in fibrotic liver disease and how Resmetirom is filling that gap. He explains the drug’s novel mechanism of action as a thyroid hormone receptor beta (THR-β) agonist, its ability to reduce triglycerides within liver cells, and its impact on reducing inflammation and fibrosis. Drawing from real-world experience with over 100 patients on therapy, Dr. Hogan discusses the favorable safety profile—primarily mild and self-limited GI side effects—and emphasizes why every liver care provider should be considering Resmetirom as a frontline option beyond lifestyle interventions. Tune in for a practical, expert-led update on one of the most significant advancements in liver disease management in decades.