Bezafibrate for the treatment of primary sclerosing cholangitis.
BACKGROUND
It is known that bezafibrate decreases serum alkaline phosphatase (ALP) in patients with hyperlipidemia, and the efficacy of this drug for the treatment of primary biliary cirrhosis has been confirmed. However, there has been little evidence of its efficacy for the treatment of primary sclerosing cholangitis (PSC).


METHODS
Bezafibrate (400 mg/day) was orally administered to 7 consecutive patients with PSC, and we analyzed their clinical features and the drug efficacy in terms of the effect on hepatobiliary enzymes, including ALP, gamma-glutamyl transpeptidase (gamma-GTP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) after 6 months. The latest hepatobiliary enzyme levels were also evaluated.


RESULTS
In 3 patients (effective group), the levels of all hepatobiliary enzymes had decreased after 6 months. Mean ALP had decreased to approximately 40% of the baseline in this group. The efficacy of bezafibrate was observed for a long period (range, 8-27 months) in these 3 patients. There seemed to be no definite association between the efficacy of bezafibrate and the clinical features in the short term.


CONCLUSIONS
This study showed that bezafibrate could lower the levels of hepatobiliary enzymes in about half of a cohort of patients with PSC.
Mizuno
Suguru
S
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Hirano
Kenji
K
Tada
Minoru
M
Yamamoto
Keisuke
K
Yashima
Yoko
Y
Yagioka
Hiroshi
H
Kawakubo
Kazumichi
K
Ito
Yukiko
Y
Kogure
Hirofumi
H
Sasaki
Takashi
T
Arizumi
Toshihiko
T
Togawa
Osamu
O
Matsubara
Saburo
S
Nakai
Yousuke
Y
Sasahira
Naoki
N
Tsujino
Takeshi
T
Isayama
Hiroyuki
H
Kawabe
Takao
T
Omata
Masao
M
Koike
Kazuhiko
K
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood / Q000187:drug effects; D001629:Bezafibrate / Q000494:pharmacology / Q000627:therapeutic use*; D015209:Cholangitis, Sclerosing / Q000188:drug therapy* / Q000201:enzymology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000960:Hypolipidemic Agents; D000469:Alkaline Phosphatase; D001629:Bezafibrate