Advances in Primary Biliary Cholangitis: Expert Insights on Emerging Data and Key Treatment Innovations - Episode 7

The Efficacy of PPAR Agonists in PBC: Signals of Extrahepatic Improvements

Published on: February 16, 2026

Frances Lee, MD, Aparna Goel, MD, A. Sidney Barritt IV, MD, MSCR, Lance L. Stein, MD

Explore the latest FDA-approved second-line therapies for PBC, including seladelpar and elafibranor, and their mechanisms of action.

EP. 1: An Overview of PBC Pathophysiology, Severity, and Burden

EP. 2: Key Symptoms of PBC- Fatigue, Pruritus, and Bone Health

EP. 3: Assessing Disease Severity and Progression Risk in PBC

EP. 4: Diagnostic Criteria in PBC: What Clinicians are Looking For

EP. 5: Experts Review the First- and Second-Line Treatment Options for PBC

EP. 6: How Special Populations and Disease Risk Impact Treatment Assessment in PBC

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EP. 7: The Efficacy of PPAR Agonists in PBC: Signals of Extrahepatic Improvements

EP. 8: The Safety of PPAR Agonists in PBC: Reviewing Recent Trial Data

This episode, titled “The Efficacy of PPAR Agonists in PBC: Signals of Extrahepatic Improvements,” features panelists discussing the mechanisms of action for both approved second-line therapies, elafibranor and seladelpar. They highlight the secondary fatigue and pruritus improvements observed in both agents and how that informs treatment decisions.

Led by the moderator, the experts examine the following critical questions:

If first-line treatment response is inadequate, there are currently two approved second-line treatments: elafibranor and seladelpar. Please compare and contrast the mechanisms of action among these two agents.
What have we learned about the efficacy of PPAR agonists from the primary trials of elafibranor (ELATIVE) and seladelpar (RESPONSE)?
What have we learned about the durability and biochemical impact of long-term elafibranor (ELATIVE OLE) or seladelpar (ASSURE OLE) from their respective open-label extension trials?

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, “The Safety of PPAR Agonists in PBC: Reviewing Recent Trial Data,” panelists will continue their discussion on PBC and highlight safety data from the ELATIVE and RESPONSE trials.