Скачать или смотреть Navigating Treatment Options: Second-Line Therapies in a Post-OCA World

In this video, Dr. Robert Brown from Weill Cornell Medicine in New York discusses what patients with primary biliary cholangitis (PBC) should know when discontinuing obeticholic acid (Ocaliva). For many, coming off Ocaliva can feel overwhelming, especially if the treatment has been effective in reducing alkaline phosphatase levels and slowing disease progression. Dr. Brown explains that while biochemical response may diminish after stopping, the long-term benefits gained are not lost immediately, since PBC is typically a slow-progressing condition. He outlines the key decisions patients face—whether to pause and monitor changes or transition directly to a second-line therapy. Importantly, two FDA-approved second-line therapies, seladelpar and elafibranor, are now available, both targeting PPAR pathways with unique benefits such as reduced itch and improved fatigue. Dr. Brown emphasizes that switching from Ocaliva does not require tapering or washout, and treatment choices should be guided by side-effect profiles, insurance coverage, and patient preferences. With new therapies available and more in development, patients and providers have multiple safe and effective options for long-term management of PBC.