MSRA-0680

A 50-year-old female with a history of Sjogren’s syndrome presents to the gastroenterology clinic with elevated liver function tests. She reports experiencing fatigue and itching that has worsened over the past 3 months. On physical examination, her abdomen is soft, nontender, and without any organ enlargement. Laboratory results show a low hemoglobin level, normal platelet count and white blood cell count, elevated bilirubin, alkaline phosphatase, and gamma-glutamyl transferase levels, and positive anti-mitochondrial antibodies. What is the initial treatment recommended to halt the progression of her liver disease?