Primary biliary cirrhosis: Pathophysiology, clinical presentation and therapy

Table 3 Drug therapy for primary biliary cirrhosis

Drug	Mechanism(s) of action	Adverse effects
Ursodeoxycholic acid	Protection of cholangiocytes, stimulation of biliary secretions of bile acids	Diarrhea, hepatic decompensation (rare)
Corticosteroids	Anti-inflammatory, especially useful for interface hepatitis	Cataracts, hyperglycemia, osteoporosis, immunosuppression, poor wound healing, weight gain
Budesonide	Anti-inflammatory, especially useful for interface hepatitis	Nausea, dyspepsia; systemic toxicity is much less than for other corticosteroids[73]
Obeticholic acid	Reduces bile acid synthesis, downregulates bile acid uptake proteins	Pruritus
Fibrates	Activates peroxisome proliferator-activated receptors	Myalgias, rhabdomyalysis, elevated liver enzymes[72]