Second line therapy
This a term used In PBC a patient does not respond to Urso - usually within a year's time from the start of dosing. A different drug of choice is needed.
The only approved second line treatment is the use of Ovaliva (obeticholic acid) . Bezafibrates (fenofibrates in the US) have been used as well along with Ocaliva but neither of these drug groups are licensed yet. Right now they are being used in clinical trials.