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July 2, 2025 12 mins

In this expert conversation, Andrea Gossard, NP, and Ann Moore, NP, share real-world strategies for managing Primary Biliary Cholangitis (PBC) with a strong focus on symptom control and quality of life. While PBC is a chronic autoimmune liver disease requiring long-term management, patients often struggle most with debilitating symptoms like pruritus (itching) and fatigue—which can significantly impact their day-to-day well-being. Gossard and Moore discuss stepwise treatment approaches for pruritus, including cholestryramine, rifampin, naltrexone, and off-label options, as well as non-pharmacologic interventions. They also explore the complex, often misunderstood nature of fatigue in PBC and the importance of patient education, support groups, and validated resources like the PBCers organization, American Liver Foundation, and GHAPP ACE app. This discussion emphasizes the need for patient-centered care, multidisciplinary collaboration, and holistic management that prioritizes both liver health and symptom relief. With new therapies and promising clinical trial data emerging, this is an encouraging time for clinicians and patients navigating the evolving landscape of PBC treatment.

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