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PBC

Podcasts

Beyond the Mic: Exploring the Journeys of Leaders.

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Cholestatic Pruritus Across the Age Spectrum: What Are You Missing?

When considering cholestatic pruritus across the age spectrum, a key point to remember is that while the underlying mechanism is similar, pediatric patients often present with unique challenges in diagnosis and management due to factors like limited communication abilities, potential side effects of medications, and the need for careful dosage adjustments; additionally, older adults might have co-morbidities that complicate treatment and require a more nuanced approach to managing pruritus

Podcasts

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Empowering PBC Patients: APPs’ Role in Education and Support

Empowering patients with Primary Biliary Cholangitis (PBC) starts with education, communication, and long-term support. In this episode, nurse practitioner Sarah Dawkins, from Duke University Medical Center, and Alison Moe, PA-C, from Atlanta Gastroenterology Associates, discuss the vital role Advanced Practice Providers (APPs) play in the longitudinal care of PBC patients. From explaining prognosis, symptoms, and treatment expectations to addressing quality-of-life challenges like fatigue, pruritus, bone density loss, and anxiety, they share practical strategies for building trust and improving patient outcomes.

You’ll hear how APPs act as the “quarterback” of care—providing education beyond the clinic visit, coordinating with multidisciplinary teams (dermatology, endocrinology, mental health, pharmacy), and connecting patients to trusted resources and support groups. Visual aids, personalized communication styles, and continuous follow-up all help patients better understand their diagnosis, medications, and long-term management.

Whether you’re a healthcare professional seeking best practices or a patient looking for clarity and support, this conversation highlights why APPs are essential in managing chronic liver disease and ensuring patients with PBC feel informed, empowered, and never alone.
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Navigating Difficult Conversations: Discussing Prognosis and Lifelong Care in PBC

In this engaging episode, nurse practitioners HoChong Gilles from the Central Virginia VA Healthcare System and Ann Moore from Arizona Liver Health share their expertise on navigating challenging conversations in the care of patients with Primary Biliary Cholangitis (PBC). They explore some of the most difficult topics to address—including disease chronicity, symptom management for fatigue and pruritus, and discussing prognosis—while offering practical communication strategies to build trust, encourage adherence, and provide hope. The conversation covers techniques like motivational interviewing, teach-back methods, and integrating educational resources with psychosocial support. HoChong and Ann highlight the importance of multidisciplinary collaboration, peer support networks, and advocacy groups in enhancing patient understanding and engagement. Whether managing asymptomatic patients, addressing treatment fatigue, or guiding those at risk for disease progression, this discussion delivers valuable, real-world insights for clinicians dedicated to improving quality of life and long-term outcomes in PBC care.
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Collaborating Across Specialties: How APPs Can Work with Hepatologists & Other Providers in PBC Care

In this engaging session from the second ADH Conference, nurse practitioner Allan Guerra and physician assistant Jhuli Patel discuss the importance of collaboration across specialties in the management of patients with Primary Biliary Cholangitis (PBC). Drawing from their respective experiences in solo and group GI practices, they highlight the critical role Advanced Practice Providers (APPs) play in identifying, diagnosing, and managing this rare liver disease. The conversation explores how effective communication with gastroenterologists, hepatologists, medical science liaisons, and multidisciplinary care teams—including social workers and office managers—can improve care coordination, medication access, and patient education. Julie and Alan also emphasize using evidence-based guidelines and leveraging EHR platforms like Athena to track labs and imaging. This session reinforces the value of teamwork and advocacy in delivering seamless, patient-centered care for individuals with PBC.
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Webcasts

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PBC Case Presentation With Dr. Brown

Primary Biliary Cholangitis (PBC) is a chronic, cholestatic autoimmune liver disease that, when diagnosed early, can be effectively managed to improve outcomes and reduce the risk of liver transplantation. In this in-depth video, we follow a representative patient case to highlight how PBC often presents subtly—most commonly in women over 45 with fatigue, pruritus, or mildly abnormal liver tests—and why it is frequently misdiagnosed as fatty liver disease. Viewers will learn why an elevated alkaline phosphatase (ALP), combined with a positive anti-mitochondrial antibody (AMA), is sufficient for diagnosis, and why early intervention is critical.

We explore the clinical utility of immunoglobulin testing, ANA, serum bile acids, and the appropriate use of ultrasound, MRCP, and liver biopsy to confirm diagnosis or rule out overlap syndromes and biliary obstruction. This video offers practical guidance on staging with non-invasive tools like elastography and emphasizes the importance of starting ursodeoxycholic acid (UDCA) as first-line therapy for all diagnosed patients. You’ll also learn when to initiate second-line treatments such as obeticholic acid (OCA), elafibranor, or seladelpar, especially in patients who are incomplete responders or intolerant to UDCA.

Clinicians will also gain strategies for managing PBC-associated symptoms like pruritus and fatigue, monitoring fat-soluble vitamin levels, and determining when to refer patients to a transplant center. The discussion is grounded in clinical trial data and real-world experience, reinforcing the critical role of ALP normalization in predicting transplant-free survival and long-term patient outcomes. Whether you’re a gastroenterologist, hepatologist, or primary care provider managing liver disease, this comprehensive guide offers the latest evidence-based strategies to optimize care for patients with PBC.
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PBC Progression and Benefits of Early Diagnosis

Primary Biliary Cholangitis (PBC) is a chronic autoimmune liver disease that often begins with the presence of anti-mitochondrial antibodies (AMA)—even before liver tests become abnormal. In this video, we explore the significance of AMA positivity, why early detection matters, and how untreated cholestasis can silently progress to fibrosis, bile duct loss, and ultimately liver failure.

Learn how to interpret AMA results in asymptomatic patients, the importance of monitoring alkaline phosphatase and serum bile acids, and why abnormal bilirubin is a late marker of disease. We also discuss common missteps in diagnosis, the impact of gender on outcomes, and why men with PBC often fare worse—likely due to later diagnosis or differing disease biology.

Clinicians are encouraged to maintain a high index of suspicion for PBC in patients with a cholestatic liver enzyme pattern—even if symptoms are subtle like pruritus. Most importantly, this video emphasizes a critical message: early treatment changes outcomes. With timely intervention, liver transplant for PBC has become far less common.
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What is PBC?

Primary Biliary Cholangitis (PBC) is a chronic cholestatic liver disease and part of the broader spectrum of autoimmune liver conditions. In this educational overview, we explain how autoimmune diseases can target different parts of the liver: hepatocytes in autoimmune hepatitis, small bile ducts in PBC, and large bile ducts in PSC (Primary Sclerosing Cholangitis).

You'll also learn why the name changed from Primary Biliary Cirrhosis to Primary Biliary Cholangitis—a shift that reflects earlier diagnosis before cirrhosis develops, and aims to improve accuracy and patient understanding. We break down the rationale behind the terminology, highlight the concept of overlap syndromes, and emphasize the importance of early recognition and management of PBC as an autoimmune cholangiopathy.

This video is ideal for providers, patients, and caregivers seeking a deeper understanding of PBC and how it fits within the autoimmune liver disease landscape.
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Publications

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Expert Perspectives on PBC: Interactive Management Algorithm and Chatbot

Abstract Library

Unlocking Boundless Knowledge Through Abstracts

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FCRL3 as a potential link between Benzo[a]pyrene exposure and primary biliary cholangitis: insights from comparative toxicogenomics and multi-omics analysis.

Han Zongze (Z);Ran Ying (Y);Liu Ruiyun (R);Dong Shijing (S);Li Jiwen (J);Zhang Xue (X);Chen Nian (N);Wang Can (C);Wang Bangmao (B);Zhou Simin (S);Zhou Lu (L)

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Impact of Type 2 Diabetes Mellitus on Liver Fibrosis and Hepatic Steatosis in Patients with Primary Biliary Cholangitis: A Longitudinal Study.

Williams Elizabeth E (EE);Lammert Craig (C);Vuppalanchi Raj (R)

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Dysgeusia-Driven Nutritional Decline in Cirrhosis: A Case of Autoimmune Hepatitis and Primary Biliary Cholangitis.

Rahming Newton (N);Corcho Stephan (S);Olowe Oluwasegun (O);Falls Leila (L);Manikkavelu Murali K (MK);Tiesenga Frederick (F)