Document Detail


Bezafibrate treatment of primary biliary cirrhosis following incomplete response to ursodeoxycholic acid.
MedLine Citation:
PMID:  19881358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND GOALS: Ursodeoxycholic acid (UDCA) is the only current pharmacologic treatment for primary biliary cirrhosis (PBC). However, some patients show persistent liver biochemical abnormalities even after 6 to 12 months treatment. Bezafibrate retard is a commonly used medication for hyperlipidemia. In Japanese studies, it was found to lower liver enzyme levels, apparently through its action on multiple drug resistance gene 3, a transport element of the ATP-dependent bile secretion system, and on peroxisome proliferator-activated receptor-alpha. The aim of this study was to evaluate the effect of adding bezafibrate to the treatment regimen in patients with PBC and a partial response to UDCA. STUDY: The study group included 8 White patients, 7 women and 1 man, aged 52 to 76 years with PBC who had been treated at our Liver Institute with UDCA (900 mg/d to 1500 mg/d) for 2 to 11 years (mean, 5.7 y) with only a partial response (19% to 56% reduction in alkaline phosphatase level). Bezafibrate (400 mg/d) was added to UDCA and the patients were followed for 4 to 12 months. RESULTS: Alkaline phosphatase levels (normal range, 35 to 104 U/L) decreased in all patients, from 140 to 360 U/L (mean, 201.2) to 68 to 158 U/L (mean, 98.4), and normalized in 6 patients. In addition, levels of gamma-glutamyl transferase (normal range, 6 to 42 U/L) decreased from 70 to 192 U/L (mean, 130) to 41 to 122 U/L (mean, 71.8). These findings were maintained throughout follow-up. CONCLUSIONS: Combination therapy with bezafibrate and UDCA improves the biochemical profile of patients with PBC who respond only partially to UDCA. A larger controlled study is needed to evaluate the clinical implications of these findings.
Authors:
Rawi Hazzan; Ran Tur-Kaspa
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  44     ISSN:  1539-2031     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  371-3     Citation Subset:  IM    
Affiliation:
Department of Medicine D, Liver Institute, Rabin Medical Center Beilinson Hospital, Sackler School of Medicine Tel-Aviv University, Petah-Tikva, Israel. rawihazzan@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Alkaline Phosphatase / blood
Antilipemic Agents / administration & dosage,  therapeutic use*
Bezafibrate / administration & dosage,  therapeutic use*
Cholagogues and Choleretics / administration & dosage,  therapeutic use
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Liver Cirrhosis, Biliary / drug therapy*
Male
Middle Aged
Treatment Outcome
Ursodeoxycholic Acid / administration & dosage,  therapeutic use*
gamma-Glutamyltransferase / blood
Chemical
Reg. No./Substance:
0/Antilipemic Agents; 0/Cholagogues and Choleretics; 128-13-2/Ursodeoxycholic Acid; 41859-67-0/Bezafibrate; EC 2.3.2.2/gamma-Glutamyltransferase; EC 3.1.3.1/Alkaline Phosphatase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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