Unable to Differentiate/Identify Between Slow & Fast Progressors - Need to Manage More Aggressively

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Welcome to another episode of the GHAPP CLDF PBC Podcast Series, hosted by Andrea Gossard, NP. In this episode, we explore one of the most challenging aspects of Primary Biliary Cholangitis (PBC): identifying progression rates and implementing timely, personalized management strategies. Andrea is joined by fellow GHAPP member and hepatology expert Ann Moore, MD, who brings decades of clinical experience to the conversation. Together, they discuss how the natural history of PBC has evolved since the approval of ursodeoxycholic acid (UDCA), and why differentiating between slow and rapidly progressing patients is critical to improving long-term outcomes. The episode dives into the importance of monitoring biomarkers such as alkaline phosphatase and bilirubin, interpreting non-invasive tests like FibroScan and ELF, and understanding when to escalate to second-line therapy. Ann shares real-world strategies for risk stratification, including using CBC, imaging, and prognostic scoring tools like the GLOBE and UK-PBC scores. The discussion also touches on disparities in access to liver transplant and the economic burden of late-stage disease. If you’re a hepatology or GI provider managing patients with PBC, this episode provides actionable insights on how to intervene earlier, track disease progression more effectively, and ultimately prevent the need for liver transplantation. Don’t forget to catch the other episodes in this high-impact series on Primary Biliary Cholangitis.