Which therapy is considered disease-modifying for biliary cirrhosis?

Which therapy is considered disease-modifying for biliary cirrhosis?

• A. Cholestyramine
• B. Prednisone
• C. Acetaminophen
• D. Ursodeoxycholic acid

Answer: (D)

Ursodeoxycholic acid is the therapy that can modify the course of biliary cirrhosis. It is a hydrophilic bile acid that replaces more toxic bile acids, protects cholangiocytes and hepatocytes, and improves bile flow, which reduces cholestasis and inflammation. This slows progression to cirrhosis and can improve survival, making it the standard disease-modifying treatment for primary biliary cholangitis. The other options mainly relieve symptoms or are not proven to alter disease progression: cholestyramine helps with itching by binding bile acids in the gut but doesn’t change the disease; prednisone is not a standard disease-modifying therapy for this condition and carries significant risks; acetaminophen is simply a medication to be used cautiously in liver disease and does not affect the disease process.

Ursodeoxycholic acid is the therapy that can modify the course of biliary cirrhosis. It is a hydrophilic bile acid that replaces more toxic bile acids, protects cholangiocytes and hepatocytes, and improves bile flow, which reduces cholestasis and inflammation. This slows progression to cirrhosis and can improve survival, making it the standard disease-modifying treatment for primary biliary cholangitis. The other options mainly relieve symptoms or are not proven to alter disease progression: cholestyramine helps with itching by binding bile acids in the gut but doesn’t change the disease; prednisone is not a standard disease-modifying therapy for this condition and carries significant risks; acetaminophen is simply a medication to be used cautiously in liver disease and does not affect the disease process.