AGA/AASLD Clinical Practice Guideline on Management of Primary Biliary Cholangitis

Background & aims: Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease associated with progressive fibrosis, cirrhosis, liver transplantation, and premature mortality. Despite effective therapies, important challenges remain in the diagnosis and management of PBC, including identification of antimitochondrial antibody-negative disease, assessment of response to ursodeoxycholic acid (UDCA), risk stratification, treatment of patients with inadequate response, management of cholestatic pruritus, and prevention of recurrent disease after liver transplantation. The aim of this guideline was to develop evidence-based recommendations addressing these key areas of clinical care.

Methods

The American Gastroenterological Association (AGA) and the American Association for the Study of Liver Diseases (AASLD) convened a multidisciplinary panel to develop clinical practice recommendations for adults with PBC. Systematic reviews were performed for 6 prioritized clinical questions. The Grading of Recommendations Assessment, Development and Evaluation framework was used to prioritize clinical outcomes and assess evidence, and its Evidence to Decision Framework was used to develop recommendations.