James Boyer, MD

Improving Strategies for Management of Primary Biliary Cholangitis 

In the final segment of our HCPLive Special Report on Updates and Unmet Needs in Primary Biliary Cholangitis, Palak Trivedi, MD, PhD, and James Boyer, MD, discuss strategies for better supporting 

 patients in managing their condition. Boyer underscores the importance of early diagnosis, particularly in primary care, and advocates for increased awareness among primary care physicians about PBC and the significance of testing for anti-mitochondrial antibodies in at-risk patients. They also highlight the need to address side effects like pruritus comprehensively.

Trivedi mentions a recent initiative from the Netherlands, which involves a patient-facing document that helps patients optimize their consultations with healthcare providers. This tool aims to enhance value-based healthcare by enabling patients to better communicate their needs and concerns during medical visits, reflecting the broader goals of patient empowerment and improved disease management.

Check out the other segments in this series:

Advances in Diagnostic Criteria and Methods for Early Detection of PBC

Updates in Therapeutic Approaches to PBC Following Elafibranor Approval

Clinical and Patient Perspectives on Unmet Needs in PBC Management

Beyond Current Standards: Emerging Therapies for Primary Biliary Cholangitis

Improving Strategies for Management of Primary Biliary Cholangitis

James Boyer, MD, Ensign Professor of Medicine at Yale School of Medicine and the Founder and Emeritus Director of the Yale Liver Center.

Palak Trivedi, MD, PhD, Associate Professor and Honorary Consultant Hepatologist and Clinical Research Director for Industry Engagement at the University of Birmingham. Also serves as an investigator on the open-label ASSURE trial of seladelpar in patients with PBC.

Videos

In this video segment, Palak and Trivedi discuss strategies for improving the management of patients in real-world settings given recent advances in therapies and pathophysiology.

In this segment of our HCPLive Special Report on Updates and Unmet Needs in Primary Biliary Cholangitis, Palak Trivedi, MD, PhD, and James Boyer, MD, explore emerging therapies for 

 and their potential impact. Trivedi expresses enthusiasm for next-generation PPAR agonists and ileal bile acid transporter inhibitors (IBAT inhibitors), which have shown promise in treating congenital cholestasis disorders and are now being tested in PBC and PSC.

He highlights the potential of these agents to reduce cholestasis and improve cognitive impairment and fatigue, marking them as first-in-class treatments for these symptoms. James Boyer, MD, adds that preliminary results for IBAT inhibitors have shown significant improvements in pruritus and fatigue, indicating their potential to lower bile acid pool size and reduce liver inflammation. The discussion emphasizes the need for continued observation and validation through further studies.

In this video segment, Palak and Trivedi dive into a discussion on emerging therapies and therapeutic targets for management of PBC.

 Clinical and Patient Perspectives on Unmet Needs in PBC Management

In this segment of our HCPLive Special Report on Updates and Unmet Needs in PBC, Palak Trivedi, MD, PhD, and James Boyer, MD, delve into the major unmet needs in PBC management from both clinical and patient perspectives. Trivedi stresses the goal of achieving lower alkaline phosphatase levels to extend patient life expectancy and improve quality of life for patients with 

. They discuss the partial success of new drugs in normalizing these levels and the potential necessity of combination therapies.

From the patient’s viewpoint, while newer therapies have shown promise in reducing pruritus, significant challenges remain in addressing cognitive dysfunction and fatigue associated with PBC. Trivedi calls for incorporating health-related quality of life tools and patient-reported outcomes in efficacy trials to better address these aspects.

In this video segment, Palak and Trivedi break down their perspectives on the current state of unmet need in primary biliary cholangitis from a clinical and patient perspective. 

In this segment of our HCPLive Special Report on Updates and Unmet Needs in PBC, Palak Trivedi, MD, PhD, and James Boyer, MD, focus their discussion on recent therapeutic advancements in 

, particularly the approval of new treatments like elafibranor and the anticipated approval of seladelpar. When prompted, Boyer provides a historical context, noting that the standard of care was previously ursodeoxycholic acid, with a significant portion of patients not responding adequately. He outlines the progression to obeticholic acid, its limitations, and the need for new therapies.

The conversation then highlights the efficacy of elafibranor and seladelpar, both of which have shown promising results in clinical trials. Boyer explains the importance of achieving significant reductions in alkaline phosphatase levels, a key prognostic marker, and the challenges of side effects like pruritus with existing therapies. The discussion underscores the potential of these new treatments to improve patient outcomes and quality of life.

In this video segment, Palak and Trivedi discuss the approval of elafibranor and other therapies that could receive approval for management of primary biliary cholangitis in the near future. 

James Boyer, MD

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