From the Research
Plasma exchange therapy has not been established as a standard treatment for primary sclerosing cholangitis (PSC) and its use is still experimental. The provided evidence does not directly support the use of plasma exchange therapy in PSC, and the most recent study 1 does not mention it as a treatment option. The current primary medical therapy for PSC is ursodeoxycholic acid, which improves biochemical parameters of cholestasis and is safe at low doses 1, 2, 3. Some key points to consider in the management of PSC include:
- The disease is characterized by chronic biliary inflammation and fibrosis, leading to strictures, bacterial cholangitis, and decompensated liver disease 1.
- There is a strong association with inflammatory bowel disease, and patients with PSC are at increased risk of colorectal cancer and cholangiocarcinoma 1, 4.
- Liver transplantation is the definitive treatment for advanced disease, with recurrent PSC occurring in up to 38% of patients 1.
- Several novel therapeutic strategies are in development, including apical sodium-dependent bile acid transporter and ileal bile acid transporter inhibitors, integrin inhibitors, and peroxisome proliferator-activated receptor agonists 1. Given the lack of evidence supporting the use of plasma exchange therapy in PSC, it is not recommended as a standard treatment option, and patients should discuss the potential benefits and risks of this experimental therapy with specialists experienced in both PSC management and apheresis procedures.