Approximately one-third of patients with primary biliary cholangitis (PBC) fail to respond to ursodeoxycholic acid (UDCA) and are at risk for progression to biliary cirrhosis and end-stage liver disease. In this paper by Pares et al., the authors evaluate the effect of long-term use of bezafibrate in patients with primary biliary cholangitis (PBC) and inadequate response to UDCA. They found that addition of bezafibrate led to normalization of serum alkaline phosphatase in half of the study subjects and major improvement in pruritus. Here we discuss these findings and place them in context with current knowledge about fibrates in PBC.
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