AGA/AASLD Clinical Practice Guideline on Management of Primary Biliary Cholangitis.

The AGA/AASLD guideline for adults with primary biliary cholangitis agrees on 6 evidence-based recommendations spanning diagnosis, UDCA optimization, risk stratification, escalation, pruritus, and post-transplant prevention.

• Why it matters: Primary biliary cholangitis is linked to progressive fibrosis, cirrhosis, liver transplantation, and premature mortality, yet key diagnostic and management challenges remain.
• What they did: A multidisciplinary AGA/AASLD panel developed recommendations for adults with PBC using systematic reviews for 6 prioritized clinical questions, applying GRADE and an Evidence to Decision Framework.
• The result: The guideline recommends PBC-specific antinuclear antibodies for antimitochondrial antibody-negative suspected PBC, UDCA as first-line therapy, liver stiffness measurement for prognostication, PPAR agonists for inadequate UDCA response or intolerance, linerixibat for moderate to severe pruritus, and UDCA prophylaxis after transplantation to reduce recurrence.