Fibrates for the Treatment of Primary Biliary Cholangitis Unresponsive to Ursodeoxycholic Acid: An Exploratory Study
| Autor: | 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 |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Frontiers in Pharmacology Frontiers in Pharmacology, Vol 12 (2022) |
| ISSN: | 1663-9812 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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