A consensus integrated care pathway for patients with primary biliary cholangitis: a guideline-based approach to clinical care of patients

Gideon M Hirschfield (1, 2) , Olivier Chazouillères (3, 4, 3) , Helena Cortez-Pinto (5) , Guilherme Macedo , Victor de Lédinghen (6) , Femi Adekunle , Marco Carbone (7)

1 University Health Network [Toronto, ON, Canada]
2 University of Toronto
3 CHU Saint-Antoine [AP-HP]
4 CRSA - Centre de Recherche Saint-Antoine
5 ULISBOA - Universidade de Lisboa = University of Lisbon
6 BaRITOn - Bordeaux Research In Translational Oncology [Bordeaux]
7 UNIMIB - Università degli Studi di Milano-Bicocca = University of Milano-Bicocca

Introduction: Primary biliary cholangitis (PBC) is an infrequent, immune-mediated cholestatic liver disease, which can lead to liver fibrosis, cirrhosis and complications of end-stage liver disease. The established goals of treatment of PBC are prevention of end-stage liver disease and amelioration of associated symptoms. The European Association for the Study of the Liver (EASL) management guidelines provide extensive recommendations on the diagnosis and management of PBC. Areas covered: This article describes the development by expert consensus of a 'PBC Integrated Patient Care Pathway' to simplify and standardize the management of PBC for clinicians based on current practice. Expert opinion: Guideline adoption is potentially poor in practice since most patients with PBC in the community are seen by general gastroenterologists or hepatologists without a special interest in autoimmune liver disease. The PBC Integrated Patient Care Pathway is a best practice tool for clinicians designed to complement the EASL Clinical Practice Guidelines for the diagnosis and management of PBC patients. It gives clinicians a practical decision tree of the key steps in PBC management, thereby providing a simplified framework and an opportunity for more uniform practice that supports the safe and timely adoption of varied models of care provision to patients with PBC.

Mots clés: American association for the study of liver diseases (aasld); european association for the study of the liver (easl); obeticholic acid (oca); patient care pathway; primary biliary cholangitis (pbc); ursodeoxycholic acid (udca)

Domaines: Sciences du Vivant [q-bio]

Gideon M Hirschfield, Olivier Chazouillères, Helena Cortez-Pinto, Guilherme Macedo, Victor de Lédinghen, et al.. A consensus integrated care pathway for patients with primary biliary cholangitis: a guideline-based approach to clinical care of patients. Expert Review of Gastroenterology & Hepatology, 2021, pp.1 - 11. ⟨10.1080/17474124.2021.1945919⟩. ⟨hal-03283884⟩