The episode emphasizes how cirrhosis is best understood in stages—from earlier phases where lifestyle changes and preventive care can make a meaningful difference, to more advanced stages that require closer management and support. A major theme throughout the conversation is the importance of a multidisciplinary approach, with hepatologists working alongside nutritionists, radiologists, transplant teams, and other specialists to provide comprehensive, patient-centered care.

Listeners will also gain insight into how modern hepatology is evolving, including the growing role of imaging, nutrition, and collaboration across specialties. This high-level overview is ideal for healthcare professionals looking to better understand the broader strategy behind managing cirrhosis and portal hypertension, while staying aligned with current trends in liver disease care and improving long-term patient outcomes.

Looking ahead, the discussion focuses on the exciting progress being made across genetics, diagnostics, and treatment development. Learn how new research is uncovering a broader understanding of how common Wilson’s disease may actually be, along with emerging technologies that could enable earlier and more accurate detection. The episode also touches on the evolution of treatment approaches, including improvements to existing therapies and the potential for innovative options on the horizon.

This high-level overview is ideal for hepatology providers, gastroenterology clinicians, and advanced practice providers who want to stay informed on where the field is headed—without getting lost in complex clinical detail. Discover why Wilson’s disease is entering a new era of innovation and what that could mean for improving patient outcomes in the years ahead.

Listeners will gain a high-level understanding of when to consider Wilson’s disease, why early detection is so important, and how clinicians approach the diagnostic journey. The discussion also touches on the role of family history, the complexities of confirming a diagnosis, and the evolving tools that support better identification of the disease. This episode is ideal for healthcare professionals looking for a clear, accessible overview of Wilson’s disease and its impact on liver health, without getting lost in overly technical details.

Rather than focusing on individual therapies in depth, this session highlights how clinicians are thinking differently about preventing complications, improving long-term outcomes, and using newer, less invasive tools to guide decision-making. It also touches on the broader impact of complications like liver failure, fluid buildup, and cognitive changes, while reinforcing the importance of proactive management and patient-centered care. This overview is ideal for healthcare professionals looking to stay current on the direction of hepatology and the evolving strategies shaping chronic liver disease management.

Additionally, it reviews absolute contraindications such as heart failure, severe pulmonary hypertension, and uncontrolled infection, emphasizing the need for multidisciplinary decision-making. Finally, emerging data on smaller stent diameters (6–8 mm) are discussed, demonstrating how these innovations may reduce complications while maintaining effective portal decompression.

This episode is essential for clinicians managing portal hypertension, cirrhosis complications, and liver transplant candidates.

The discussion also covers subclinical portal hypertension and the use of HVPG and non-invasive tools for early risk stratification, along with practical applications across patient populations, including MASLD and post-hepatitis C patients. Additionally, it explores the impact of metabolic disease and obesity on cirrhosis progression, emphasizing the need for multidisciplinary, personalized management strategies.

A concise overview for clinicians looking to stay current on evolving approaches in liver disease and HCC surveillance.

The episode also covers the Baveno VII criteria, demonstrating how non-invasive tools like liver stiffness and platelet count can safely reduce the need for screening endoscopies. Additionally, it outlines the “beta blocker window,” helping clinicians determine when to initiate or discontinue therapy based on blood pressure, renal function, and signs of decompensation.

A concise, clinically relevant overview for providers managing patients with cirrhosis and portal hypertension.

Dr. Brown also explains best practices for ongoing follow-up of patients on antiviral therapy, emphasizing viral suppression monitoring, medication adherence, and hepatocellular carcinoma surveillance with ultrasound and alpha-fetoprotein in appropriate patients. Additional topics include counseling patients on transmission prevention, screening and management during pregnancy, and the importance of hepatitis B testing before chemotherapy or immunosuppressive therapy to prevent viral reactivation. This overview provides practical guidance for clinicians and advanced practice providers caring for patients with chronic hepatitis B.

He outlines thresholds for therapeutic response and reviews the FDA-approved second-line therapies, including obeticholic acid and the three new agents approved in summer 2024, while addressing safety concerns and boxed warnings. Dr. Bonder also underscores the need to address quality of life, managing symptoms like fatigue, pruritus, and abdominal pain—often overlooked but impactful for patients with PBC. With clinical pearls on when to escalate care or refer for liver transplantation, this session offers a comprehensive, practical roadmap for optimizing PBC outcomes today and in the future.

In this practical and patient-focused video, Dr. Nadege Gunn, a hepatologist based in Waco, Texas, shares essential diet and lifestyle strategies for individuals living with Primary Biliary Cholangitis (PBC). Addressing a common question—“What can I eat or do to feel better?”—Dr. Gunn highlights the benefits of a balanced, Mediterranean-style diet rich in fruits, vegetables, nuts, seeds, fish, and olive oil. She emphasizes bone health as a key concern for PBC patients, recommending adequate intake of vitamin D and calcium, resistance-based exercises, and regular weight-bearing activity. The video also stresses the importance of monitoring fat-soluble vitamin levels (A, D, E, and K), avoiding alcohol, and supplementing with a multivitamin if needed. Dr. Gunn further underscores the role of maintaining a healthy weight, staying active, avoiding smoking, and ensuring hepatitis A and B vaccinations to prevent additional liver complications. Whether you're a provider looking to guide patients or someone living with PBC seeking actionable advice, this video offers valuable lifestyle recommendations to help manage the disease and improve overall liver health.

In this thoughtful discussion, Dr. Nancy Reau from RUSH University Medical Center explores the often-overlooked psychological impact of Primary Biliary Cholangitis (PBC). While managing the physical symptoms of PBC is critical, addressing the emotional and mental health challenges faced by patients is equally important. Dr. Reau highlights how the lifelong nature of PBC, its familial implications, unpredictable progression, and extrahepatic symptoms like fatigue and pruritus can contribute to significant stress, anxiety, and emotional strain. Many patients may appear physically healthy yet suffer from symptoms that disrupt their daily lives and relationships—leading to frustration, isolation, and misunderstood expectations from others. Even those in biochemical remission can experience mental health burdens, especially if they’ve seen loved ones struggle with the disease. Dr. Reau emphasizes the need for providers to initiate open conversations about these psychological effects to validate patient experiences and support overall wellness. If you're a clinician or caregiver seeking a more holistic approach to PBC management, or a patient navigating the emotional side of liver disease, this video offers compassionate, practical guidance.

In this insightful discussion, Dr. Tatyana Kushner, hepatologist and associate professor at Weill Cornell Medicine, explores the critical issue of medication adherence in patients living with Primary Biliary Cholangitis (PBC). While ursodeoxycholic acid (ursodiol) remains the cornerstone of first-line therapy for PBC, up to half of patients express uncertainty or reluctance about taking it consistently. Dr. Kushner delves into the complex barriers affecting adherence, including lack of symptom relief, fear of side effects, misunderstanding of long-term benefits, pill burden from multiple daily doses, and socioeconomic challenges such as medication costs and insurance coverage. She also addresses the impact of extrahepatic symptoms—like pruritus, fatigue, and depression—which can further discourage regular medication use. Importantly, certain subgroups, such as younger patients and males, have been shown to be at higher risk for non-adherence and may require additional support. If you're a healthcare provider managing PBC or a patient navigating treatment, this video offers valuable insights into improving adherence and outcomes.

In this engaging update from the Allied Digestive Health Annual Conference, Dr. Sonal Kumar, hepatologist at Weill Cornell Medicine, shares the latest advancements in diagnosing and managing Primary Biliary Cholangitis (PBC). Dr. Kumar emphasizes the importance of early assessment and intervention—highlighting the limitations of outdated treatment algorithms that delay evaluation for second-line therapy. Instead, clinicians are now encouraged to assess patients as early as 6 months after starting ursodeoxycholic acid (UDCA), especially those with elevated alkaline phosphatase (ALP), advanced fibrosis, or younger age. The discussion also explores the evolving treatment goals in PBC, including a shift toward normalization of ALP and bilirubin levels as key biomarkers of disease activity and prognosis. Dr. Kumar highlights exciting data from the ELATIVE and RESPONSE trials, which led to the approval of two new PPAR agonists—elafibranor and seladelpar—offering improved ALP normalization rates and even symptom relief for pruritus. This marks a significant turning point in how hepatologists approach symptom management in PBC, with fatigue and pruritus now recognized as critical components of care. Learn more about this evolving treatment landscape and how these advancements are shaping a more personalized, proactive approach for patients living with PBC.

In this comprehensive discussion, Hetal Karsan, Chair of Medical Education at United Digestive, explores how to manage complications of Primary Biliary Cholangitis (PBC) and their impact on patient quality of life. PBC is a chronic autoimmune cholestatic liver disease that primarily affects women—but is increasingly diagnosed in men. Dr. Karsan breaks down the progression from inflammation to fibrosis and cirrhosis, and emphasizes how early diagnosis and adherence to treatment with ursodeoxycholic acid (UDCA) can dramatically improve outcomes.

Learn practical strategies to monitor liver function, prevent and manage complications such as variceal hemorrhage, ascites, hepatic carcinoma, and osteoporosis. Discover the importance of normalizing alkaline phosphatase and bilirubin, supporting nutrition and vitamin levels, and reducing risk through lifestyle changes. Dr. Karsan also highlights how fatigue and pruritus impact daily life for patients with PBC and discusses both pharmacologic and non-pharmacologic ways to help. From screening recommendations to emotional support and patient education, this video is a vital guide for healthcare providers treating PBC.

Discover the evolving landscape of Primary Biliary Cholangitis (PBC) treatment with Dr. Huiming Sooki Hon from United Digestive. In this expert-led discussion, Dr. Sooki Hon reviews both established and emerging therapies for PBC, beginning with first-line treatment using ursodeoxycholic acid (UDCA) and the importance of early diagnosis and biochemical monitoring. Learn why normalization—not just reduction—of alkaline phosphatase is becoming a new treatment goal, and why up to 40% of patients may require second-line therapy. Dr. Sooki Hon outlines the latest FDA-approved options, including obeticholic acid, elafibranor, and seladelpar, highlighting their mechanisms of action, efficacy, and key safety considerations. This video also explores promising investigational therapies and combination strategies aimed at slowing disease progression and improving symptom control. Whether you're a healthcare professional or a patient seeking updated information on PBC management, this comprehensive overview provides valuable insights into current standards and future directions.

Join Dr. Steven Flamm, Rush University Medical School, and Dr. Naim Alkhouri, Arizona Liver Health, for an in-depth discussion on Resmetirom — the first FDA-approved treatment for adults with MASH (Metabolic Dysfunction-Associated Steatohepatitis) and moderate to advanced fibrosis. In this expert-led podcast, the panel explores the groundbreaking clinical data behind Resmetirom, including findings from the MAESTRO-NASH trial, which demonstrated fibrosis regression and NASH resolution after just one year of treatment. Drs. Flamm and Alkhouri review real-world patient experiences, optimal use of non-invasive tests (like FibroScan, ELF, and MRI-PDFF), practical monitoring strategies, and common questions on dosing, side effects, and access.

This conversation also addresses treatment selection, synergistic use of Resmetirom with GLP-1 receptor agonists, and how to approach medication continuation or discontinuation in responders. For liver care providers managing patients with MASLD and MASH, this podcast offers valuable guidance on how to incorporate this landmark therapy into practice.

Dr. Reed Hogan, a practicing gastroenterologist in Jackson, Mississippi, shares his clinical experience and insights on Resmetirom, the first FDA-approved therapy for MASH (Metabolic Dysfunction-Associated Steatohepatitis). With over 6,000 patients screened annually in his metabolic and fatty liver clinics, Dr. Hogan highlights the urgent need for effective treatment options in fibrotic liver disease and how Resmetirom is filling that gap. He explains the drug’s novel mechanism of action as a thyroid hormone receptor beta (THR-β) agonist, its ability to reduce triglycerides within liver cells, and its impact on reducing inflammation and fibrosis. Drawing from real-world experience with over 100 patients on therapy, Dr. Hogan discusses the favorable safety profile—primarily mild and self-limited GI side effects—and emphasizes why every liver care provider should be considering Resmetirom as a frontline option beyond lifestyle interventions. Tune in for a practical, expert-led update on one of the most significant advancements in liver disease management in decades.

In this expert journal club summary, Dr. Meena Bansal—System Chief for the Division of Liver Diseases at the Icahn School of Medicine at Mount Sinai and Director of the MASH Center of Excellence—explains the significance of the newly adopted nomenclature for fatty liver disease. She reviews the multi-society Delphi consensus statement that led to the transition from NAFLD/NASH to MASLD/MASH, emphasizing the need to remove stigmatizing language and more accurately reflect the metabolic underpinnings of the disease. Dr. Boshell highlights the international collaboration behind the change, involving 56 countries, patient advocacy groups, and leading researchers. This video explores the rationale behind using the umbrella term “steatotic liver disease,” the inclusion of MetALD to reflect patients with both metabolic dysfunction and alcohol use, and how this new framework supports future research in genomics, proteomics, and precision medicine. Tune in to learn how this global consensus is shaping the future of liver disease classification and clinical trials.

In this clinical overview, Dr. Kimberly Brown, Associate Medical Director for Liver Transplantation at Henry Ford Hospital, provides a comprehensive update on Resmetirom — the first FDA-approved therapy for adults with MASH (Metabolic Dysfunction-Associated Steatohepatitis) and moderate to advanced fibrosis (F2–F3). Dr. Brown reviews the approved indication for Resmetirom, explains which patients are eligible for treatment, and offers practical guidance on dosing based on body weight and drug interactions. She also addresses common questions regarding use in patients with thyroid conditions and those already on GLP-1 therapies. With a favorable safety profile and minimal side effects—mainly mild nausea and diarrhea—Resmetirom represents a significant breakthrough in managing progressive liver disease. Learn more about proper dosing strategies, drug interactions (including statin use), and how to identify appropriate patients who may benefit from this liver-targeted therapy.

In this insightful video, Dr. Kimberly Brown, Associate Medical Director for Liver Transplantation at Henry Ford Hospital, breaks down the current understanding of disease progression in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). Dr. Brown reviews the estimated timelines—from simple steatosis to inflammation and fibrosis, and ultimately cirrhosis—and highlights key risk factors including age, type 2 diabetes, uncontrolled metabolic conditions, genetic predisposition, and alcohol use. She also reviews guidance from the AASLD on fibrosis reassessment timelines and explains why identifying "fast progressors" remains a clinical challenge. Watch now to gain practical insights into monitoring fibrosis progression, interpreting risk factors, and determining when intensified follow-up or treatment may be warranted.

In this expert update, Dr. Kimberly Brown, Associate Medical Director for Liver Transplantation at Henry Ford Hospital, discusses Resmetirom—the first and only FDA-approved treatment for Metabolic Dysfunction-Associated Steatohepatitis (MASH). Resmetirom is a thyroid hormone receptor beta (THR-β) agonist that targets the liver to reduce triglyceride levels, leading to both NASH resolution and fibrosis regression. Dr. Brown highlights key clinical trial data showing significantly better outcomes with Resmetirom compared to placebo, including improvements in liver histology for patients with stage F2–F3 fibrosis. She addresses common questions about placebo response rates, side effect profiles (such as mild nausea and diarrhea), and the drug’s liver-specific mechanism of action with minimal systemic effects. Although not approved for patients with cirrhosis, ongoing trials may further expand its clinical use. Tune in to learn why Resmetirom represents a major step forward in treating MASH and how it fits into the evolving landscape of liver disease care.

In this expert-led educational video, Dr. Kimberly Brown—Professor of Medicine at Wayne State University and Michigan State University and Transplant Hepatologist at Henry Ford Hospital—breaks down the stages of MASH progression, from early steatosis and inflammation to advanced liver fibrosis and cirrhosis. Dr. Brown explains how untreated MASH can lead to serious complications including portal hypertension, hepatic encephalopathy, variceal bleeding, ascites, liver cancer, and ultimately liver transplantation. With MASH now being the leading cause of liver transplant listings in the U.S., this video underscores the urgency of early intervention and long-term disease management. Watch now to understand the natural history of MASH and why proactive treatment is critical in preventing advanced liver disease. Available on both the CLDF and MASH Alliance websites.

Welcome to Episode 7 of the GHAPP CLDF PBC Podcast Series, hosted by Andrea Gossard, NP. In this pivotal episode, we explore the cumulative impact of nonresponse to ursodeoxycholic acid (UDCA) in patients with Primary Biliary Cholangitis (PBC). Andrea is joined by Anne Moore, NP, a GHAPP board member and expert in PBC management, to discuss the concept of “area under the curve” as it relates to prolonged biochemical nonresponse and progressive liver injury over time. Together, they emphasize the critical need for early identification of inadequate response, how to define therapeutic targets (such as normalization of alkaline phosphatase and bilirubin), and why timely escalation to second-line therapies is key to preventing long-term complications like advanced fibrosis, cirrhosis, hepatocellular carcinoma (HCC), and portal hypertension. This episode also provides valuable insights into esophageal varices screening, bone health monitoring, and the economic and access-related challenges of liver transplant, particularly in rural areas. With evidence-based commentary and real-world strategies, this conversation empowers hepatology and GI providers to recognize the importance of ongoing monitoring, proactive treatment adjustments, and comprehensive care planning for patients with PBC. Don't miss this essential episode in a series focused on advancing liver care.

Welcome to another episode of the GHAPP CLDF PBC Podcast Series, hosted by Andrea Gossard, NP. In this episode, we explore one of the most challenging aspects of Primary Biliary Cholangitis (PBC): identifying progression rates and implementing timely, personalized management strategies. Andrea is joined by fellow GHAPP member and hepatology expert Ann Moore, MD, who brings decades of clinical experience to the conversation. Together, they discuss how the natural history of PBC has evolved since the approval of ursodeoxycholic acid (UDCA), and why differentiating between slow and rapidly progressing patients is critical to improving long-term outcomes. The episode dives into the importance of monitoring biomarkers such as alkaline phosphatase and bilirubin, interpreting non-invasive tests like FibroScan and ELF, and understanding when to escalate to second-line therapy. Ann shares real-world strategies for risk stratification, including using CBC, imaging, and prognostic scoring tools like the GLOBE and UK-PBC scores. The discussion also touches on disparities in access to liver transplant and the economic burden of late-stage disease. If you’re a hepatology or GI provider managing patients with PBC, this episode provides actionable insights on how to intervene earlier, track disease progression more effectively, and ultimately prevent the need for liver transplantation. Don’t forget to catch the other episodes in this high-impact series on Primary Biliary Cholangitis.

Welcome to the eighth and final episode of the GHAPP CLDF PBC Podcast Series, hosted by Andrea Gossard, ARNP. In this powerful conclusion to our educational journey on Primary Biliary Cholangitis (PBC), we shift focus toward a holistic approach to PBC management, emphasizing lifestyle modifications, integrative medicine, symptom relief, and long-term well-being beyond standard pharmacologic therapy. Andrea is joined once again by Christina Hanson, FNP-C and GHAPP board member, for a deep dive into the comprehensive care strategies that support not just liver health, but the overall quality of life in patients with PBC. Together, they discuss how to manage extrahepatic manifestations such as fatigue, pruritus, bone disease, dyslipidemia, and fat-soluble vitamin deficiencies, while also addressing common patient concerns around statin use, alcohol consumption, and over-the-counter supplements. With insights on lifestyle counseling, diet, exercise, vitamin D, sleep hygiene, and non-pharmacologic approaches like meditation and complementary therapies, this episode offers actionable takeaways for clinicians and patients alike. Whether you're treating PBC in Detroit, Denver, or anywhere across the U.S., this episode reinforces the importance of a patient-centered, multidisciplinary strategy to optimize care in this complex liver disease. Don't forget to explore the full podcast series for more expert-led discussions on PBC.

Welcome to the CLDF GHAPP PBC Podcast Series! In this episode of our eight-part series, host Andrea Gossard, NP, is joined by Christina Hanson, FNP and CLDF GHAPP board member, to explore the evolving role of biomarkers in the diagnosis, monitoring, and personalized treatment of Primary Biliary Cholangitis (PBC). Together, they examine how clinicians are rethinking the utility of traditional markers such as alkaline phosphatase and bilirubin, and how newer data support the use of additional biomarkers—including ALT, AST, and GGT—for a more comprehensive picture of disease activity and therapeutic response. This discussion includes practical guidance on baseline evaluation with FibroScan, interpretation of liver stiffness measurements, and when to consider second-line therapies. Christina shares her clinical insights from real-world hepatology practice, emphasizing the importance of early intervention, individualized timelines for assessing treatment response, and the growing recognition that even small elevations in liver enzymes may signal a need for more aggressive care. This episode is a must-listen for hepatology providers and GI specialists who want to stay up to date with the latest evidence-based strategies in PBC management. Subscribe and follow along as we continue this educational journey throughout the full series.

Welcome to the CLDF/GHAPP PBC Podcast Series. In this episode, Dr. Kimberly Brown, Associate Medical Director at Henry Ford Hospital in Detroit, Michigan, is joined by Dr. Sonal Kumar, Assistant Professor of Medicine and Director of Clinical Hepatology at Weill Cornell in New York City. Together, they explore the real-world management of Primary Biliary Cholangitis (PBC), focusing on optimizing first-line therapy with ursodiol (UDCA) and the shift toward earlier initiation of second-line therapies. The conversation highlights evidence-based dosing strategies, side effects commonly seen with ursodiol—such as GI discomfort and hair loss—and the variation in tolerability among different generic formulations. Drs. Brown and Kumar also discuss how clinicians are rethinking the timing for evaluating response, moving from the traditional 12-month window to as early as 3 to 6 months, based on changes in alkaline phosphatase and bilirubin levels. They share how they prepare patients for second-line therapy, set expectations, and use lab trends and annual FibroScan assessments to demonstrate treatment success—even when symptoms may not noticeably improve. This episode provides expert insights from two leading hepatologists in Detroit and New York City, offering practical, patient-centered strategies for improving long-term outcomes in PBC management.

In this episode of the CLDF/GHAPP PBC Podcast Series, Dr. Kimberly Brown, Professor of Medicine at Henry Ford Hospital in Detroit, Michigan, and Dr. Sonal Kumar, Assistant Professor and Director of Clinical Hepatology at Weill Cornell Medicine in New York City, explore how clinical practice is evolving when it comes to earlier intervention and individualized treatment in Primary Biliary Cholangitis (PBC). With second-line therapies now available, the discussion centers on when to move beyond ursodiol (UDCA), how to evaluate response using markers like alkaline phosphatase and bilirubin, and why the traditional 12-month assessment window is shifting earlier to 3 or 6 months. Drs. Brown and Kumar share insights from their respective practices, emphasizing a more proactive and personalized approach to managing PBC patients—especially those with advanced fibrosis at baseline, men, and patients from underrepresented populations who may be at higher risk for progression. They also discuss the importance of treatment normalization, monitoring response trends over time, and using early biochemical signals to determine the need for second-line therapies. This episode provides real-world perspectives from hepatology leaders in two major academic centers, highlighting the importance of shifting away from “wait-and-see” models and toward timely, aggressive care that optimizes long-term outcomes in PBC.

In this episode of the CLDF GHAPP PBC Podcast Series, Dr. Kimberly Brown joins Dr. Steven Flamm for an important discussion on building a sense of urgency around evaluating and monitoring patients with Primary Biliary Cholangitis (PBC). Together, they explore how clinical practice has evolved to recognize the variability and unpredictability of PBC progression, emphasizing the importance of early assessment, frequent follow-up, and timely adjustments to therapy. Drawing on new guidance from the CLDF and their own experience at major transplant centers, Drs. Brown and Flamm stress the importance of tracking alkaline phosphatase and bilirubin levels as key indicators of disease activity and risk. They highlight that certain high-risk populations—such as men, patients of color, and younger individuals—require even closer monitoring due to more aggressive disease trajectories. The conversation also addresses the need to reassess patients within three to six months of initiating therapy, the clinical implications of inadequate response to first-line treatment with ursodiol (URSO), and when to consider second-line options. Additionally, the episode explores the intersection of PBC and other liver conditions like MASH, underscoring the importance of a comprehensive approach in complex patients. This discussion, rooted in real-world hepatology practice in the Midwest, offers practical, timely guidance for clinicians nationwide who are striving to deliver optimal care for patients with PBC.

Welcome to the CLDF GHAPP PBC Podcast Series. In this episode, Dr. Kimberly Brown is joined by Dr. Steven Flamm for an in-depth discussion on primary biliary cholangitis (PBC). Together, they explore the unpredictable progression of PBC to fibrosis and cirrhosis, offering real-world insights into how liver disease develops even in patients who may not exhibit symptoms early on.

The conversation emphasizes the importance of early diagnosis, close monitoring, and timely intervention to improve outcomes. Drs. Brown and Flamm dive into non-invasive methods for assessing fibrosis—including elastography and proprietary serum biomarkers—and discuss why simple tools like APRI and FIB-4 are helpful for initial risk stratification but less reliable for monitoring long-term disease progression. They also discuss the clinical significance of rising bilirubin levels in PBC, the limitations of routine imaging in identifying advancing fibrosis, and the importance of identifying secondary causes of liver disease.

This episode also touches on when to consider second-line therapies, how to identify candidates for liver cancer screening, and the role of transplant centers in managing advanced disease. If you’re a clinician treating PBC or other chronic liver conditions, this conversation provides valuable guidance on how to optimize care and improve outcomes across the entire spectrum of liver disease.