Understanding fatigue in primary biliary cholangitis: From pathophysiology to treatment perspectives

Table 1 Conditions and drugs contributing to fatigue burden[1,2]

Conditions	Drugs
Addison disease; Anaemia; Autonomic dysfunction; Cancer; Chronic Lyme disease; Dehydration; Depression; Diabetes; Heart failure; Hypothyroidism; Infectious/inflammatory state; Myasthenia gravis; Multiple sclerosis; Obstructive sleep apnoea; Parkinson’s disease; Pregnancy; Renal failure; Restless legs syndrome; Tuberculosis	Antibiotics; Antidepressants; Anti-hypertensive therapy; Muscle relaxants; Opioids; Sedative-hypnotics

Table 2 Failed therapeutic options and future therapeutic perspectives for fatigue in primary biliary cholangitis

Treatment for fatigue in PBC	Ref.
Failed therapeutic options
Ursodeoxycholic acid	Angulo et al[32], 1999
Obeticholic acid	Hirschfield et al[33], 2015
Budesonide	Hirschfield et al[37], 2021
Fluoxetine	Talwalkar et al[18], 2006
Fluvoxamine	ter Borg et al[19], 2004
Ondansetron	Theal et al[20], 2005
Rituximab	Khanna et al[14], 2019
Modafinil	Silveira et al[16], 2017
Methotrexate	Combes et al[48], 2005
Oral antioxidant supplementation	Prince et al[23], 2003
Lifestyle changes
Morning bright light treatment	Turco et al[15], 2018
Home-based exercise programme	Freer et al[46], 2021
Possible future therapeutic options
Fibrates	Corpechot et al[35], 2018
Plasmapheresis	Wunsch et al[40], 2021
S-adenosyl-L-methionine	Wunsch et al[45], 2018
Seladelpar	Kremer et al[44], 2022

PBC: Primary biliary cholangitis.