From the Research
For patients with Primary Biliary Cholangitis (PBC), Obeticholic acid (Ocaliva) is the more effective option compared to Seladelpar, based on recent clinical evidence. The most recent and highest quality study 1 highlights Obeticholic acid (OCA) as the only approved second-line treatment for PBC, effective for non-responders to UDCA therapy or patients who have not tolerated UDCA therapy. Key points to consider include:
- OCA has proven to be effective in improving surrogate markers of prognosis in PBC, as noted in 2 and 3.
- Seladelpar, on the other hand, is mentioned in 4 as a prospective second-line therapy, but its efficacy and safety profile are not as well-established as OCA for PBC.
- The treatment approach for PBC typically begins with UDCA, and when response is inadequate, second-line agents like OCA may be considered, as outlined in 1 and 5.
- It's crucial to individualize treatment decisions based on patient characteristics, comorbidities, and treatment goals, with regular monitoring of liver function tests, as emphasized in 2 and 4. Some potential side effects and considerations for OCA include pruritus, which may be a limiting factor for its administration, as mentioned in 1 and 4. However, given the current evidence, OCA is the preferred choice over Seladelpar for the treatment of PBC, due to its established efficacy and safety profile.