title: Treatment of primary biliary cirrhosis with ursodeoxycholic acid, budesonide and fibrates.
abstract: Long-term treatment with ursodeoxycholic acid (UDCA; 13-15 mg/kg/day) in patients with primary biliary cirrhosis (PBC) improves biochemical liver tests, delays histological progression and prolongs survival without liver transplantation. UDCA monotherapy appears sufficient for many patients as suggested by long-term observational data. However, the transplant-free survival rate of UDCA-treated patients remains significantly lower than that of an age- and sex-matched control population. Therefore, there is a continued need for new therapeutic options in PBC. In this article we review and discuss the following issues: the appropriate selection of patients requiring new therapeutic options, the role of budesonide in the management of these patients, and the emerging place of peroxisome proliferator-activated receptor-α ligands as anti-inflammatory and immunomodulating agents in PBC.
authors.affiliation: UPMC Univ Paris 06, INSERM, UMR_S 938, Service d'Hépatologie et Centre de Référence des Maladies Inflammatoires des Voies Biliaires, Hôpital Saint-Antoine, AP-HP, Paris, France. raoul.poupon@sat.aphp.fr
authors.forename: Raoul
authors.initials: R
authors.lastname: Poupon
mesh_terms: D000328:Adult; D019819:Budesonide / Q000627:therapeutic use*; D005260:Female; D058607:Fibric Acids / Q000627:therapeutic use*; D006801:Humans; D008099:Liver / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
chemical_list: D058607:Fibric Acids; D019819:Budesonide; D014580:Ursodeoxycholic Acid