Table 6.

Symptoms in PBC and corresponding treatment option

Symptom	Treatment	Description
Fatigue	Modafinil	RCT failed to show efficacy
Pruritus	Anion-exchange resins (cholestyramine)	The first-line treatment, despite limitations
	Rifampicin	The second-line treatment
	µ-opioid receptor antagonists (naloxone or naltrexone)	The second-line treatment
	κ-opioid receptor agonist (nalfurafine hydrochloride)	Approved only in Japan
	Ileal bile acid transporter inhibitor	Linerixibat; efficacy was shown in the Phase 2a; now global phase 2b (NCT02966834)
		Maralixibat; failed to show efficacy
	Bezafibrate	Now being investigated (NCT02701166)
Sicca syndrome	Artificial tears and saliva	Should be initially used
	Pilocarpine or cevimeline	May be helpful in refractory cases

PBC, primary biliary cholangitis; RCT, randomized clinical trial.