Author information

• ¹Toronto Centre for Liver Diseases, University Health Network and University of Toronto, Toronto, Canada.
• ²Assistance Publique - Hôpitaux De Paris (APHP), Reference Centre for Inflammatory Biliary Diseases and Autoimmune Hepatitis (CRMR, MIVB-H), Department of Hepatology Saint-Antoine Hospital, Sorbonne Université, INSERM, Saint-Antoine Research Center, Paris, France.
• ³Clínica Universitária De Gastrenterologia, Faculdade De Medicina, Universidade De Lisboa, Lisbon, Portugal.
• ⁴Gastroenterology and Hepatology Department, Centro Hospitalar São João, Porto, Portugal.
• ⁵Hepatology Unit, Bordeaux University Hospital, Pessac, & INSERM U1053, Bordeaux University, Bordeaux, France.
• ⁶Intercept Pharmaceuticals, Europe Ltd. London, UK.
• ⁷Division of Gastroenterology, Centre for Autoimmune Liver Disease, University of Milan-Bicocca, Milan, Italy.

Abstract

Introduction: Primary biliary cholangitis (PBC) is an infrequent, immune-mediated cholestatic liver disease, which can lead to liver fibrosis, cirrhosis and complications of end-stage liver disease. The established goals of treatment of PBC are prevention of end-stage liver disease and amelioration of associated symptoms. The European Association for the Study of the Liver (EASL) management guidelines provide extensive recommendations on the diagnosis and management of PBC.

Areas covered: This article describes the development by expert consensus of a 'PBC Integrated Patient Care Pathway' to simplify and standardize the management of PBC for clinicians based on current practice.

Expert opinion: Guideline adoption is potentially poor in practice since most patients with PBC in the community are seen by general gastroenterologists or hepatologists without a special interest in autoimmune liver disease. The PBC Integrated Patient Care Pathway is a best practice tool for clinicians designed to complement the EASL Clinical Practice Guidelines for the diagnosis and management of PBC patients. It gives clinicians a practical decision tree of the key steps in PBC management, thereby providing a simplified framework and an opportunity for more uniform practice that supports the safe and timely adoption of varied models of care provision to patients with PBC.