Published: 15 April 2026
Author(s): Antonella Ruiu, Maria Pia Calabrese, Pietro Meschisi, Riccardo Plebani, Maria Buzias, Ana Lleo, Vincenzo Ronca
Issue: April 2026
Section: Invited Review Article

Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease characterized by progressive destruction of the small intrahepatic bile ducts. If is left untreated, the resulting cholestasis leads to fibrosis and ultimately cirrhosis. The disease predominantly affects middle-aged women but also occurs in men and younger individuals. Advances in therapy have dramatically improved outcomes; however, a significant proportion of patients experience suboptimal biochemical response to the first-line agent, ursodeoxycholic acid (UDCA), necessitating escalation to second-line or combination therapy [1–3].

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