Clinical features and management of primary biliary cirrhosis

Table 5 Clinical management of metabolic bone disease associated with primary biliary cirrhosis

Clinical management	Efficacy
	Moderate efficacy	Mild efficacy, insufficient data
Prevention
1 Parenteral vitamin D3 supplementation	Indicated for all patients to prevent osteomalacic lesions
2 Calcium carbonate supplementation
Treatment
1 Estrogen		Few data but effective and safe
2 Etidronate		Conflicting data
		Indicated in case of concomitant corticosteroid administration
3 Alendronate		Few data but effective and safe
4 Calcitonin		Probably ineffective