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CME: Cholangiopathy management updates with an eye on the horizon: focus on primary biliary cholangitis

ACCREDITATION EXPIRED: July 19, 2026

Activity Description / Statement of Need:

In this online, self-learning activity:

Cholestatic liver diseases are characterized by a disruption of bile flow in the biliary tree. They include a range of biliary diseases that affect the biliary epithelium, resulting in cholestasis, inflammation, fibrosis, and cirrhosis, and they account for about 14% of liver transplants in the US. One of the most common progressive cholangiopathies that primarily affects adults is primary biliary cholangitis (PBC). Formerly known as primary biliary cirrhosis, PBC involves the progressive fibrosis of the small intrahepatic bile ductules, and its prevalence ranges between 1.91 to 40.2 per 100,000. Its pathogenesis has not been well-defined but is thought to involve environmental triggers leading to an immune hyper-response and inflammation in those who are genetically susceptible. The median predicted survival for patients with PBC is six to 16 years with rates differing between asymptomatic patients and symptomatic patients (16 vs. 7.5 years, respectively). Those diagnosed with the disease also experience decreased productivity and lower quality of life (QOL).

Target Audience:

HCPs including: gastroenterologists, hepatologists, and primary care; nurse practitioners, physician assistants, and pharmacists who practice in the aforementioned areas of specialty; and those who otherwise commonly care for or clinically encounter patients with PBC.


Commercial Support Disclosure: This program is supported by an educational grant from Intercept Pharmaceuticals. 

This activity is free of charge.


Release Date: July 19, 2024 -- Expiration Date: July 19, 2026

Faculty: Gina Choi, MD

Agenda

Faculty introduction, disclosures

Introduction content: progressive cholangiopathies—PBC 

  • Epidemiology
  • Genetics and pathophysiology
  • Diagnosis: differential; risk of delaying or missing; and diagnostic principles
  • Complications and health burden
  • Prognosis

Medical management for PBC

  • The roles of:
    • UDCA
    • Roles of off-label use of presently approved medications
  • Investigational therapies for PBC—mechanisms of action and anticipated places in therapy of agents that may include:
    • Peroxisome proliferator-activated receptor agonists
    • A bile acid transporter inhibitor
    • Novel immunomodulatory agent(s)
  • Monitoring: ALP, other liver function tests, and fibrosis
    • Charting of disease progression
    • Determining the need for second-line treatment
  • Role of liver transplantation
  • Management strategies not already reviewed for symptoms
    • Pruritis
    • Fatigue
    • Dry mouth, eyes
  • Patient case(s) 

Summary, conclusion, and best practice gap

Learning Objectives

By the end of the session the participant will be able to:

  • Summarize the health burden unique to patients with PBC and challenges to their optimal identification and management.
  • Recall the present therapies for PBC and their roles in the treatment paradigm.
  • Develop a treatment plan for a patient with PBC.

Accreditation

ACCME Activity #202796238

ACCREDITATION FOR THIS COURSE HAS EXPIRED. YOU MAY VIEW THE PROGRAM, BUT CME / CE IS NO LONGER AVAILABLE AND NO CERTIFICATE WILL BE ISSUED.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosures of Faculty: Gina Choi, MD, Health Sciences Associate Clinical Professor of Medicine and Surgery, David Geffen School of Medicine at UCLA, has received financial compensation from Intercept, Gilead, Madrigal and Ipsen for speaker's bureau work. 

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures. 

Faculty WILL NOT discuss off-label uses of a commercial product. 

All relevant financial relationships have been mitigated. 

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Intercept Pharmaceuticals.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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Cholangiopathy management updates with an eye on the horizon: focus on primary biliary and primary sclerosing cholangitis