Management of cholestatic disease in 2017

Abstract

Primary biliary cholangitis ( PBC ) and primary sclerosing cholangitis ( PSC ) are the most frequent chronic cholestatic liver diseases and serve as model diseases to discuss the management of cholestasis in 2017 in the lecture that is summarized in this report. PBC and PSC are characterized by inflammation and fibrosis of small intrahepatic ( PBC ) or larger intra- and/or extrahepatic ( PSC ) bile ducts. Bile duct damage leads to cholestasis and can progress to liver fibrosis and even cirrhosis. Various genetic, environmental and endogenous factors may contribute to the development of chronic cholestatic liver diseases, but the exact pathogenesis of PBC and PSC has not been clarified. Ursodeoxycholic acid ( UDCA ) is the standard treatment of PBC and is used also for other cholestatic conditions including PSC , and it exerts anticholestatic effects at adequate doses. Novel anticholestatic therapeutic options for patients not adequately responding to UDCA are under development or have, like obeticholic acid, already been proven to have efficacy when combined with UDCA in the treatment of PBC . The future role of immunomodulating/immunosuppressive drug regimens must be critically reviewed.

 
K E Y W O R D S
cholestasis , farnesoid X receptor , nuclear receptor agonists , peroxisome proliferator-activated
receptor α , ursodeoxycholic acid

About Speaker

Ulrich BEUERS

Prof. Dr.

Netherlands

City: Amsterdam

Institution: Academic Medical Center, University of Amsterdam

Contact: u.h.beuers@amc.uva.nl


Biography of Ulrich BEUERS

Ulrich Beuers is Full Professor, Program Director of Gastroenterology and Hepatology and Head of Hepatology at the Academic Medical Center, University of Amsterdam, The Netherlands. Professor Beuers was formerly affiliated with the University of Munich (Germany). He received his medical training at the Universities of Ghent (Belgium), Berlin and Freiburg (Germany), postdoctoral research training in Biochemistry with the University of Göttingen (Germany), specialty training in Internal Medicine, Gastroenterology and Hepatology with the University of Munich (Germany) and the Yale University, New Haven (CT, USA) where he also was visiting professor in 2015. He was awarded his medical and doctoral degree at the University of Freiburg in 1983 and his ‘habilitation’ (the German extended PhD) at the University of Munich in 1994. Professor Beuers is chairman of the Netherlands Association for the Study of the Liver, the Netherlands Education Committee of Gastroenterology and Hepatology, and has chaired the EASL Clinical Practice Guidelines Committee on management of cholestatic liver diseases. He serves as Associate Editor of the Journal of Hepatology and on editorial boards of Hepatology and Gut, among various others.

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