# Alternative treatment approaches in primary biliary cholangitis
Primary biliary cholangitis (PBC) is treated in regular medical practice with medicines such as ursodeoxycholic acid and fenofibrate, aimed at slowing disease progression. Additionally, researchers worldwide are investigating complementary and alternative approaches. This tab describes which treatment approaches outside standard therapy are known, and what research shows about them.
Traditional Chinese medicine
Fuzheng Huayu formula
ResearchediPositive results in clinical studies, not yet standard treatment
Fuzheng Huayu is a composition of Chinese herbs being investigated in laboratory studies for effects against liver fibrosis. Recent research suggests that the formula can influence processes in liver cell development that play a role in PBC. This occurred in test tube studies and animal research. Whether this is also effective in PBC patients has not yet been demonstrated. Clinical trials in humans have not been reported.
Jianpi Huayu decoction
ResearchediPositive results in clinical studies, not yet standard treatment
This traditional herbal mixture is being tested in laboratory studies for effects against liver fibrosis through fat metabolism and certain cell signals. So far, only animal experiments and cell culture studies have been published. Evidence that it is effective in PBC patients is lacking.
Yinchenhao decoction
ResearchediPositive results in clinical studies, not yet standard treatment
Yinchenhao is a traditional Chinese formula used in cholestasis. A review of recent literature describes possible mechanisms of action in obstructive jaundice, but this mainly concerns theoretical and animal experimental data. Controlled clinical studies in PBC patients have not been demonstrated.
Senkyunolide A
ExperimentaliOngoing in study setting, outcome still unknown
This is an active substance from a Chinese medicinal plant that appears to show effects against liver fibrosis in laboratory investigations. The investigations took place in cells and animals. Human application in PBC has not been investigated.
Lycium barbarum (Goji) peptidoglycans
ExperimentaliOngoing in study setting, outcome still unknown
A substance fraction from goji berries was tested in mice and showed effects on liver fibrosis and intestinal flora. This is very preliminary research with no clinical trials in humans.
Physical treatment approaches
Double filtration plasmapheresis (DFPP)
ResearchediPositive results in clinical studies, not yet standard treatment
This is a blood purification procedure that has been tried in a few patients with severe, drug-resistant elevated cholesterol during cholestasis. There are reported cases of improvement, but no controlled study data. This is considered in very specific situations and only in specialized centres.
Genetic and cellular approaches
Targeted investigation of cellular signals
ExperimentaliOngoing in study setting, outcome still unknown
Investigations focus on specific cell mechanisms (such as Wnt signalling and TGF-β pathways) involved in PBC fibrosis formation. These are still in the pre-clinical phase. Applications for patients do not yet exist.
Microbiome-targeted approaches
ResearchediPositive results in clinical studies, not yet standard treatment
There is growing interest in the role of intestinal flora in PBC, as the disease is linked to altered bacterial composition. Some nutrients and plant substances can influence this flora. This research is still mainly experimental; clinical recommendations for specific interventions have not yet been established.
What you need to know about alternative approaches in PBC
**Why is research needed?**
PBC is a chronic disease in which current medicines work well for many patients, but do not provide complete remission for everyone. Researchers are therefore looking for additional ways to slow down or stop fibrosis formation and progression.
**Why are these treatments not yet standard?**
Most alternative approaches do not yet have clinical trials behind them. That is to say: observations in test tubes or animals are not the same as proven effectiveness and safety in patients. Much research stems from traditional Chinese medicine, which means its use has centuries-old roots there, but that says nothing about scientific evidence.
**Safety and interactions**
Many herbs and plant substances can interact with regular medicines, especially therapies related to liver conditions. Some preparations can also be harmful to the liver themselves. It is very important to discuss all supplements and alternative treatments with your doctor first.
**Research in progress**
Chinese herbal research is substantial and is published in scientific journals. This does not automatically mean that these remedies are effective for PBC patients in the Netherlands. Only well-conducted clinical trials can establish this.
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_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._