“…The autoimmune liver disease, primary sclerosing cholangitis (PSC) remains an enigma; the aetiopathogenesis remains unknown, and medical treatment options are limited. 1 However, whilst earlier studies from tertiary centres suggested a median survival of 8-10 years, recent studies have shown a median survival of 21 years. 2 With the advent of new therapies in development for PSC, the need for accurate surrogate endpoints in place of survival free of liver transplantation or death has become increasingly important.…”