Need for Clinicians to Better Understand The "Area Under the Curve" in Non-Response to UDCA

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Welcome to Episode 7 of the GHAPP CLDF PBC Podcast Series, hosted by Andrea Gossard, NP. In this pivotal episode, we explore the cumulative impact of nonresponse to ursodeoxycholic acid (UDCA) in patients with Primary Biliary Cholangitis (PBC). Andrea is joined by Anne Moore, NP, a GHAPP board member and expert in PBC management, to discuss the concept of “area under the curve” as it relates to prolonged biochemical nonresponse and progressive liver injury over time. Together, they emphasize the critical need for early identification of inadequate response, how to define therapeutic targets (such as normalization of alkaline phosphatase and bilirubin), and why timely escalation to second-line therapies is key to preventing long-term complications like advanced fibrosis, cirrhosis, hepatocellular carcinoma (HCC), and portal hypertension. This episode also provides valuable insights into esophageal varices screening, bone health monitoring, and the economic and access-related challenges of liver transplant, particularly in rural areas. With evidence-based commentary and real-world strategies, this conversation empowers hepatology and GI providers to recognize the importance of ongoing monitoring, proactive treatment adjustments, and comprehensive care planning for patients with PBC. Don't miss this essential episode in a series focused on advancing liver care.