| Title: |
Fibrates for the Treatment of Primary Biliary Cholangitis Unresponsive to Ursodeoxycholic Acid: An Exploratory Study |
| Authors: |
Guilherme Grossi Lopes Cançado; Cláudia Alves Couto; Laura Vilar Guedes; Michelle Harriz Braga; Débora Raquel Benedita Terrabuio; Eduardo Luiz Rachid Cançado; Maria Lucia Gomes Ferraz; Cristiane Alves Villela-Nogueira; Mateus Jorge Nardelli; Luciana Costa Faria; Elze Maria Gomes de Oliveira; Vivian Rotman; Daniel Ferraz de Campos Mazo; Valéria Ferreira de Almeida e Borges; Liliana Sampaio Costa Mendes; Liana Codes; Mario Guimarães Pessoa; Izabelle Venturini Signorelli; Cynthia Levy; Paulo Lisboa Bittencourt |
| Source: |
Frontiers in Pharmacology, Vol 12 (2022) |
| Publisher Information: |
Frontiers Media S.A. |
| Publication Year: |
2022 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
bezafibrate; ciprofibrate; fibrate; primary biliary cholangitis; treatment failure; ursodeoxycholic acid; Therapeutics. Pharmacology; RM1-950 |
| Description: |
Aim: Up to 40% of patients with primary biliary cholangitis (PBC) will have a suboptimal biochemical response to ursodeoxycholic acid (UDCA), which can be improved by the addition of fibrates. This exploratory study aims to evaluate the long-term real-life biochemical response of different fibrates, including ciprofibrate, in subjects with UDCA-unresponsive PBC.Methods: The Brazilian Cholestasis Study Group multicenter database was reviewed to assess the response rates to UDCA plus fibrates in patients with UDCA-unresponsive PBC 1 and 2 years after treatment initiation by different validated criteria.Results: In total, 27 patients (100% women, mean age 48.9 ± 9.2 years) with PBC were included. Overall response rates to fibrates by each validated criterion varied from 39 to 60% and 39–76% at 12 and 24 months after treatment combination, respectively. Combination therapy resulted in a significant decrease in ALT and ALP only after 2 years, while GGT significantly improved in the first year of treatment. Treatment response rates at 1 and 2 years appear to be comparable between ciprofibrate and bezafibrate using all available criteria.Conclusion: Our findings endorse the efficacy of fibrate add-on treatment in PBC patients with suboptimal response to UDCA. Ciprofibrate appears to be at least as effective as bezafibrate and should be assessed in large clinical trials as a possibly new, cheaper, and promising option for treatment of UDCA-unresponsive PBC patients. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://www.frontiersin.org/articles/10.3389/fphar.2021.818089/full; https://doaj.org/toc/1663-9812; https://doaj.org/article/848013de55a54f1fa146f49369acc9be |
| DOI: |
10.3389/fphar.2021.818089 |
| Availability: |
https://doi.org/10.3389/fphar.2021.818089; https://doaj.org/article/848013de55a54f1fa146f49369acc9be |
| Accession Number: |
edsbas.E6BEBDCB |
| Database: |
BASE |