{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T07:08:19Z","timestamp":1781334499259,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,3,30]],"date-time":"2017-03-30T00:00:00Z","timestamp":1490832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The introduction of ursodeoxycholic acid (<jats:styled-content style=\"fixed-case\">UDCA<\/jats:styled-content>)may well have contributed to some of the improvements in morbidity and mortality of primary biliary cholangitis (<jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>). Yet nearly 40% of <jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content> patients are unresponsive to <jats:styled-content style=\"fixed-case\">UDCA<\/jats:styled-content>. Further the data on <jats:styled-content style=\"fixed-case\">UDCA<\/jats:styled-content> is confounded by the changes in the goepidemiology and particularly the earlier diagnosis of <jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>. In this regard we welcome the addition of obeticholic acid (<jats:styled-content style=\"fixed-case\">OCA<\/jats:styled-content>) as an alternative therapeutic option forthe treatment of <jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content> in those patients refractory to <jats:styled-content style=\"fixed-case\">UDCA<\/jats:styled-content>. However, <jats:styled-content style=\"fixed-case\">OCA<\/jats:styled-content> is intellectually disappointing.There is no data on <jats:styled-content style=\"fixed-case\">OCA<\/jats:styled-content> that reflects dynamic and critical endpoints, for example death or liver transplantation; only surrogate endpoints have been used in the clinical trials. A nested study with liver histology wouldbeanideal surrogate marker,including intensive use of immunohistochemistry to define cellular infiltrates and cytokine\/chemokine activity. More importantly, the clinical characteristics of <jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>may vary among patients and progression is not always predictable. We need to identify more appropriate and specific biomarkers that predict the clinical course, and we need to know which therapies are applicable at different stages, since treatmentfor <jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content> should be individualized. We need to know more about the etiology of <jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>,and we want a cure for <jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/liv.13344","type":"journal-article","created":{"date-parts":[[2017,3,30]],"date-time":"2017-03-30T10:00:30Z","timestamp":1490868030000},"page":"500-502","source":"Crossref","is-referenced-by-count":23,"title":["Finding the cure for primary biliary cholangitis \u2013 Still waiting"],"prefix":"10.1111","volume":"37","author":[{"given":"Atsushi","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of Medicine Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5245-2680","authenticated-orcid":false,"given":"M. Eric","family":"Gershwin","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Allergy and Clinical Immunology University of California at Davis School of Medicine  Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,30]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28641"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1586\/1744666X.2016.1147956"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28359"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2015.10.005"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2015.08.011"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737159.2016.1164038"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2015.09.004"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2015.01.011"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2015.07.004"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13294"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509840"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28017"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.07.061"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22906"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12270"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1607744"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2016.08.007"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fliv.13344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.13344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T09:37:05Z","timestamp":1695548225000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.13344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,30]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1111\/liv.13344"],"URL":"https:\/\/doi.org\/10.1111\/liv.13344","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,30]]}}}