Ursodeoxycholic Acid for Primary Biliary Cirrhosis: With or Without Bezafibrate?

Ursodeoxycholic acid (UDCA) has been shown to improve long-term outcomes in patients with primary biliary cirrhosis (PBC); however, its efficacy is not universal in this population. Bezafibrate, a fibric acid derivative typically used to treat hyperlipidemia, was recently shown to improve patient outcomes when added to UDCA.

To assess the long-term efficacy of UDCA alone versus in combination with bezafibrate in improving outcomes in PBC, investigators in Japan randomized 27 patients to UDCA (600–900 mg daily) alone or combined with bezafibrate (400 mg daily) in a multicenter, unblinded trial. Participants had persistently elevated alkaline phosphatase (AP) >350 IU/L despite UDCA monotherapy for ≥24 weeks, and all had dyslipidemia. Endpoints…