Primary sclerosing cholangitis is a progressive cholestatic liver disease characterized by intrahepatic and extrahepatic biliary-duct fibrosis as well as associated inflammatory changes involving the portal and periportal regions of the liver. 1 The cause is unknown, although immunologic abnormalities have been described. 2 , 3 Deleterious effects of retained toxic bile acids from progressive cholestasis may also be important. Currently, there is no effective treatment. A number of medications have been evaluated, but frequently in small, uncontrolled trials of short duration. 4 – 7 Randomized, controlled trials have found no benefit from penicillamine, methotrexate, or colchicine. 8 – 10 Ursodiol (ursodeoxycholic acid) is beneficial for patients with . . .