Navigating New PBC Therapies and Treatment Monitoring With Ann Moore, NP

Primary biliary cholangitis (PBC) remains a challenging disease to manage, but advances in treatment are creating new opportunities to improve both disease outcomes and quality of life. While no therapy is perfect or universally effective, clinicians now have multiple options beyond first-line ursodeoxycholic acid (UDCA), making individualized care more achievable than ever.

At the 2025 Gastroenterology & Hepatology Advanced Practice Providers (GHAPP) conference, Ann Moore, NP, a nurse practitioner at Arizona Liver Health, broke down some of the latest advances in cholestatic disease and their impact on the field of hepatology.

Check out part 1 of the interview here!

In an interview with HCPLive, Moore emphasized the importance of monitoring and tailoring therapy based on the needs of the patient in front of you. With seladelpar (Livdelzi) and elafibranor (Iqirvo) now available as second-line treatment, she says providers now have options for how to individualize treatment.

“Years [went] by where we only had one option and there was no additional treatment,” Moore said. “Now we really have to individualize, and I think that's what's exciting about what's happening in treatment now.”

Despite expressing comfort with prescribing these newer agents, Moore noted long-term extension data are still needed, and questions remain about their impact on symptoms like pruritus and sleep.

She also underscores how far the field has come, noting that while PBC patients were once considered “rare” and left with limited options, today they are increasingly common in clinic, and management has shifted away from a “set it and forget it” model. With better tools for noninvasive monitoring, Moore says clinicians can more precisely track disease progression or improvement, adjusting therapy as needed.

“I think the key is recognizing inadequate response to first-line therapy and being aggressive with choosing your second-line therapy,” Moore said. “Don't wait a year. If a patient is not responding, if they're not where you want them to be, then consider second line therapy addition.”

Editors’ Note: This interview was recorded prior to Intercept Pharmaceuticals’ voluntary withdrawal of obeticholic acid (Ocaliva) from the US market on September 11, 2025.

References

1. Brooks A. FDA Grants Accelerated Approval to Elafibranor (Iqirvo) for PBC. HCPLive. June 10, 2024. Accessed September 15, 2025. https://www.hcplive.com/view/fda-grants-accelerated-approval-to-elafibranor-iqirvo-for-pbc

2. Brooks A. FDA Grants Accelerated Approval to Seladelpar (Livdelzi) for Primary Biliary Cholangitis. HCPLive. August 14, 2024. Accessed September 15, 2025. https://www.hcplive.com/view/fda-grants-accelerated-approval-to-seladelpar-livdelzi-for-primary-biliary-cholangitis