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Continuing Medical Education Questions: November 2021

Richter, Seth J. MD, FACG

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The American Journal of Gastroenterology: November 2021 - Volume 116 - Issue 11 - p 2172
doi: 10.14309/ajg.0000000000001530
  • Free
  • CME Test



After this activity, the participant will compare the effectiveness of obeticholic acid and fibrates in patients with primary biliary cholangitis as well as recognize potential side effects of therapy.


A 54-year-old female with a long history of primary biliary cholangitis (PBC) presents to your office for follow up. She has been maintained on ursodeoxycholic acid (UDCA) for several years with good response. She tells you she has been hearing of a new medical treatment for PBC called obeticholic acid (OCA) and another medicine called fibrate. According to this article, what can you tell her about the treatment of PBC using OCA and fibrates?

  • A. Treatment with OCA monotherapy or in combination with fibrates result in a biochemical improvement with decreases in transaminase levels, IgM levels, and markers of cholestasis in patients who do not respond to UDCA
  • B. OCA with fibrates was shown to be superior to OCA alone regarding the improvement of biochemical markers
  • C. The patient should be switched to either OCA or OCA with fibrates as they have been shown to be superior to UDCA in patients who are responding to UDCA
  • D. OCA with or without fibrates is indicated only for PBC patients with cirrhosis


The study shows that both obeticholic acid (OCA) and fibrates were successful in improving biochemical markers of disease. Fibrates were shown to be better than OCA at improving which of the following?

  • A. AST
  • B. IgM levels
  • C. Alkaline phosphatase
  • D. Platelet count


According to the article which of the following was the most common side effect of OCA therapy?

  • A. Pruritus
  • B. Diarrhea
  • C. Hemolytic anemia
  • D. Nausea

© 2021 by The American College of Gastroenterology