A novel treatment for refractory primary biliary cirrhosis?
OBJECTIVE
Bezafibrate is naturally used for hyperlipidemia worldwide. In 1992 Day et al reported that the value of ALP and gamma-GTP in hyperlipidemia declined after administering bezafibrate orally. We conducted a study to investigate whether or not ALP and gamma-GTP in primary biliary cirrhosis which is characterized by the elevation of these enzymes improved after taking bezafibrate.


METHODS
We administered bezafibrate additionally for 6 months to 13 patients with primary biliary cirrhosis (refractory PBC) whose liver enzymes (ALP or gamma-GTP) did not remain within normal range out of 21 patients treated by monotherapy of ursodeoxycholic acid for 18 months.


RESULTS
At 2, 4, and 6 months, gamma-GTP level significantly decreased compared with that prior to the initiation of bezafibrate. At 4 and 6 months, ALP level significantly decreased compared with that prior to the initiation. At 2, 4 and 6 months, ALT level significantly decreased compared with that prior to the initiation. The value of IgG and IgM was also reduced significantly 6 months after the initiation.


CONCLUSIONS
If the effectiveness of bezafibrate for primary biliary cirrhosis is confirmed histologically and by a randomized trial, a combination therapy of bezafibrate and ursodeoxycholic acid appear to be the medical treatment of choice for primary biliary cirrhosis in the future.
Miyaguchi
S
S
Department of Internal Medicine, Tokyo Metropolitan Otsuka Hospital, Tokyo, Japan. miyaguchi@mx1.ttcn.ne.jp
Ebinuma
H
H
Imaeda
H
H
Nitta
Y
Y
Watanabe
T
T
Saito
H
H
Ishii
H
H
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001629:Bezafibrate / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D000960:Hypolipidemic Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D001629:Bezafibrate