Lowering ALP
Getting ALP levels closer to normal can reduce your risk of liver damage
People with primary biliary cholangitis (PBC) have elevated levels of ALP (alkaline phosphatase) in their blood. Since an ALP level above normal could mean an increased risk of liver damage, lowering that number is an important goal of treatment—and a sign that treatment is working.* Most people with PBC take ursodiol (also called ursodeoxycholic acid, or UDCA) first to lower their ALP.
But some people don’t respond well to ursodiol, and their ALP levels remain too high, even if they’re lower than they were before. If you’re treating your PBC, your healthcare team will regularly monitor your ALP level to see how well your treatment is working. If your ALP is still higher than it should be, you may need to do more to lower your risk of liver damage.
OCALIVA is proven to deliver significant, sustained ALP reductions
OCALIVA® (obeticholic acid) is an add-on† treatment that works in a unique way to reduce toxic bile acid buildup—it may work to reduce ALP levels even more than ursodiol alone.
OCALIVA has been studied in a clinical trial where people either took OCALIVA and ursodiol together—or OCALIVA by itself (if they couldn’t tolerate ursodiol). Most people in these studies took OCALIVA in combination with ursodiol. Almost half of the people who took OCALIVA were considered “responders” to treatment.
Most people in this study took OCALIVA in combination with ursodiol. People were considered “responders” if:
- ALP was less than 1.67 times the upper limit of normal*
- ALP decreased by at least 15%
- Bilirubin levels were within the normal range‡
Some people saw a reduction in their ALP levels as early as 2 weeks after starting OCALIVA.
The effectiveness of OCALIVA in these patients is based on a study that showed a reduction in the liver enzyme ALP. There is no clinical information currently available to show if patients treated with OCALIVA live longer or if their symptoms improve. There are ongoing studies to find out how OCALIVA works over a longer period of time.
- *Many liver health markers such as ALP have a range of values that are considered normal. The top of that range is called the upper limit of normal.
- †OCALIVA is a prescription medicine used to treat PBC in combination with UDCA in adults who have not responded well enough to UDCA, or alone for adults who cannot tolerate UDCA.
- ‡Bilirubin is a separate marker of overall liver health. It is measured with a blood test. Bilirubin levels are more likely to be increased in people with PBC with advanced disease and liver damage.
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“I really wanted to bring down my ALP levels, so this seemed like it could be a good option.”
Leslie, a person living with PBC
Watch and Learn
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I’m on treatment—why are my ALP numbers still high?
Even if you’re already on treatment, there may be more you can do to manage PBC. Choose the discussion guide that best describes you, to help you have the right conversation with your doctor.