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Primary Biliary Cholangitis (PBC) Clinical Trials

Also called PBC, Primary Biliary Cirrhosis

Primary Biliary Cholangitis is a chronic progressive autoimmune liver disease characterized by destruction of intrahepatic bile ducts. The pathophysiology involves loss of tolerance to self-antigens on mitochondrial proteins (particularly PDC-E2, a component of the pyruvate dehydrogenase complex), leading to autoimmune attack primarily on small to medium-sized bile ducts.

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About Primary Biliary Cholangitis

Primary Biliary Cholangitis is a chronic progressive autoimmune liver disease characterized by destruction of intrahepatic bile ducts. The pathophysiology involves loss of tolerance to self-antigens on mitochondrial proteins (particularly PDC-E2, a component of the pyruvate dehydrogenase complex), leading to autoimmune attack primarily on small to medium-sized bile ducts. This triggers both innate and adaptive immune responses including autoreactive T cells and B cells producing antimitochondrial antibodies (AMA). Progressive bile duct destruction leads to cholestasis (impaired bile flow) and subsequent liver inflammation, fibrosis, and eventual cirrhosis if the disease progresses unchecked.

PBC typically presents insidiously with fatigue and pruritus as early symptoms. Many patients are asymptomatic at diagnosis, discovered through abnormal liver function tests on routine screening. Cholestasis markers (alkaline phosphatase, gamma-glutamyl transferase) are characteristically elevated. Antimitochondrial antibody (AMA) positivity is virtually diagnostic, present in 90-95% of patients. Progressive disease leads to portal hypertension, ascites, hepatic encephalopathy, and eventual liver failure. Ursodeoxycholic acid (UDCA), the standard first-line therapy, slows but does not halt disease progression in all patients. Approximately 25-30% of patients show inadequate biochemical response to UDCA. Bone disease (osteoporosis) is common due to cholestasis-induced malabsorption of vitamin D and increased bone turnover.

Common Symptoms of Primary Biliary Cholangitis

Recognizing the signs of Primary Biliary Cholangitis early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.

  • Fatigue, often severe and disproportionate to liver function
  • Pruritus causing intense skin itching
  • Jaundice with yellowing of skin and eyes
  • Abdominal pain and bloating
  • Osteoporosis and bone pain
  • Fat malabsorption with steatorrhea and vitamin deficiencies

Who Primary Biliary Cholangitis Affects

Predominantly affects women, with female to male ratio of 9:1. Most commonly diagnosed in women age 40-60, though can occur at any age. Rare in children and young adults. Occurs in all populations, with higher prevalence in people of European descent. Some genetic and environmental predisposition factors.

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FDA-Approved Treatments for Primary Biliary Cholangitis

There are currently 3 FDA-approved medications for Primary Biliary Cholangitis. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.

seladelpar
Gilead Sciences (developed by CymaBay Therapeutics, which Gilead acquired)
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elafibranor
Ipsen (licensed from GENFIT, which discovered it)
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linerixibat
Intercept Pharmaceuticals, a subsidiary of Alfasigma (discovered and developed by GSK)
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Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.

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Help Paying for Primary Biliary Cholangitis Treatment

Charity funds and drugmaker programs for Primary Biliary Cholangitis, checked at the source. Pick your insurance to see what fits.

Your insurance
Charity funds
  • From a charity · TotalAssist (formerly PAN Foundation)
    Primary Biliary Cholangitis fund
    Open

    Pays for: Out-of-pocket costs for approved medications, up to $2,500 per year. Requires Medicare, Medicaid or TRICARE.

  • From a charity · The Assistance Fund
    Primary Biliary Cholangitis (PBC) fund
    Waitlist

    Pays for: Copays, coinsurance, deductibles and other health-related expenses.

    The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
Status as each foundation showed it on September 28, 2026.

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Side Effect Explorer

Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.

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Genetic Testing

Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.

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Trusted Primary Biliary Cholangitis Resources

Reputable organizations and medical references for learning more about Primary Biliary Cholangitis, including disease registries, foundation resources, and clinical guidelines.

FDA decision ahead
The FDA is due to decide on Saroglitazar (Zydus Therapeutics) for Primary biliary cholangitis by November 27, 2026. Dual PPAR agonist under priority review for second-line PBC.
See all upcoming rare disease FDA decisions →

Active Clinical Trials for Primary Biliary Cholangitis

Use this Primary Biliary Cholangitis clinical trial finder to see the 19 studies recruiting patients and 1 opening soon in the United States and worldwide, with eligibility criteria in plain English. These studies play a critical role in advancing care for gastrointestinal conditions and may offer access to treatments not yet widely available. Each trial below is sourced directly from ClinicalTrials.gov, with eligibility criteria translated into plain English to help patients and caregivers evaluate whether a study may be a fit.

TrialsSite mapPipeline timeline

Note: Trial recruitment statuses on ClinicalTrials.gov may not immediately reflect recent FDA decisions, sponsor announcements, or enrollment changes. Always confirm a trial's current status directly with the study coordinator before making plans.

71 active trials worldwide
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NOT YET RECRUITINGPHASE2Recently updatedNCT07843420

Nemolizumab for the Treatment of Moderate to Severe Chronic Hepatic Pruritus

Intervention: Nemolizumab-ilto

Sponsor: Mayo Clinic

The purpose of this research is to investigate the efficacy of nemolizumab in the treatment of adults with moderate to severe chronic hepatic pruritus.

Ages 18 Years+1 location
Started Nov 2026Updated yesterdayEst. Nov 2028 (~2y 2m)
RECRUITINGRecently updatedNCT04685200

Unraveling the Mechanisms Underlying Primary Sclerosing Cholangitis Through a Multidisciplinary, Integrative Research Approach

Sponsor: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Background:

Primary sclerosing cholangitis is a rare chronic liver disease. It affects the bile ducts of the

liver. It can result in bile duct infections, cirrhosis, cancer, and end stage liver disease. Researchers want to learn more about this disease.

Objective:

Ages 18 Years – 90 Years1 location
Started Mar 2023Updated 1 week agoEst. Oct 2026 (~1 month)
RECRUITINGPHASE3Recently updatedNCT07424677

Study of Saroglitazar Magnesium for PBC Patients With Incomplete Response or Intolerant to UDCA Therapy

Intervention: Saroglitazar Magnesium 1 mg, Placebo

Sponsor: Zydus Therapeutics Inc.

Study of Saroglitazar Magnesium for PBC Patients with Incomplete Response or Intolerant to UDCA Therapy

Ages 18 Years – 80 Years1 location
Started Aug 2026Updated 2 weeks agoEst. Jul 2028 (~1y 10m)
RECRUITINGPHASE3Recently updatedNCT06051617

Seladelpar in Subjects With Primary Biliary Cholangitis (PBC) and Compensated Cirrhosis

Intervention: Seladelpar, Placebo

Sponsor: Gilead Sciences

The goal of this clinical study is to learn more about the study drug, seladelpar, and its effects on clinical outcomes in participants with primary biliary cholangitis (PBC) and compensated cirrhosis.

Ages 18 Years+213 locations
Started Sep 2023Updated 2 weeks agoEst. Aug 2030 (~3y 11m)
RECRUITINGPHASE1Recently updatedNCT06825559

Evaluate PK & Safety of Saroglitazar in Subjects With Moderate Hepatic Impairment Due to Cholestatic Liver Disease

Intervention: Saroglitazar Magnesium 1 mg

Sponsor: Zydus Therapeutics Inc.

Evaluating Pharmacokinetic and safety of Saroglitazar Magnesium 1 mg when dosed on alternate days in subjects having moderate hepatic impairment with cirrhosis due to cholestatic liver disease

Ages 18 Years – 80 Years1 location
Started Aug 2025Updated 2 weeks agoEst. Dec 2026 (~3 months)
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Active trial locations84 cities in the US
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Trial Pipeline

Jan 2021 to Sep 2031
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Data from ClinicalTrials.gov, U.S. National Library of Medicine.
Always talk to your doctor before considering a clinical trial.

Patient Communities

Connect with other Primary Biliary Cholangitis patients, caregivers, and advocacy groups across Facebook groups, Reddit communities, and YouTube channels. These patient communities offer peer support, shared experiences, caregiver resources, and real-time discussion about Primary Biliary Cholangitis treatments, clinical trial participation, and day-to-day disease management.

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Related Gastrointestinal Conditions

Other rare diseases in the gastrointestinal category. Patients with Primary Biliary Cholangitis may find relevant research, shared treatment pathways, or overlapping clinical trials among these related conditions.

Companies Developing Primary Biliary Cholangitis Treatments

11 pharmaceutical companies have Primary Biliary Cholangitis in their rare disease portfolio

Frequently Asked Questions About Primary Biliary Cholangitis