Though ursodeoxycholic acid (UDCA) remains the baseline treatment for most cholestatic liver diseases, UDCA treatment leaves approximately one-third of patients with primary biliary cholangitis (PBC) and all patients with primary sclerosing cholangitis (PSC) at risk for disease progression. New anticholestatic agents, including nuclear receptor agonists, choleretics, and bile acid synthesis suppressors, will likely increase response rates to therapy in PBC and PSC. Strategies that target early immune-mediated injury have so far been disappointing, hampered by the lack of biomarkers to detect early disease states, which then could profit from immunomodulatory therapy. Future concepts need to personalize treatments according to disease stage, progression, and phase, and to combine multiple drugs to target different pathogenic pathways.

中文翻译：

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慢性胆汁淤积性肝病的药物治疗。

尽管熊去氧胆酸（UDCA）仍然是大多数胆汁淤积性肝病的基本治疗方法，但是UDCA治疗使大约三分之一的原发性胆管性胆管炎（PBC）患者和所有原发性硬化性胆管炎（PSC）患者处于疾病进展风险中。新的抗胆碱药，包括核受体激动剂，胆汁药和胆汁酸合成抑制剂，可能会增加对PBC和PSC治疗的反应率。迄今为止，针对早期免疫介导的损伤的策略令人失望，因为缺乏检测早期疾病状态的生物标记物而受到阻碍，然后可以从免疫调节疗法中受益。未来的概念需要根据疾病的阶段，进展和阶段来个性化治疗，并结合多种药物以靶向不同的致病途径。