The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis: A prospective, multicenter study

Shinji Iwasaki, Hiromasa Ohira, Shuhei Nishiguchi, Mikio Zeniya, Shuichi Kaneko, Morikazu Onji, Hiromi Ishibashi, Isao Sakaida, Shigeki Kuriyama, Takafumi Ichida, Saburo Onishi, Gotaro Toda, E. Tomita, M. Shibata, Y. Watanabe, Yoshiaki Iwasaki, J. Hirohara, K. Nakamura, K. Kiyosawa, K. SuzukiS. Yasumura

Research output: Contribution to journalArticle

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Abstract

Aim: Treatment with ursodeoxycholic acid (UDCA) improves the survival of stage I and II primary biliary cirrhosis (PBC) patients. However, new therapeutic options are needed for patients who are refractory to UDCA and for those whose disease is at an advanced stage. Bezafibrate could be useful in PBC treatment, since it increases phospholipid output into the bile and reduces the cytotoxicity of hydrophobic bile acids, which are increased with cholestasis. Methods: We conducted two prospective, multicenter randomized open studies in non-cirrhotic patients with PBC to evaluate the efficacy of bezafibrate. One study compared UDCA and bezafibrate monotherapy (study 1: 45 patients [37 females], mean age 55.9 years), and the other evaluated the addition of bezafibrate to patients who were refractory to UDCA (study 2: 21 patients [18 females], mean age 54.1 years). Results: Study 1 demonstrated that bezafibrate monotherapy was as effective as UDCA and study 2 revealed that bezafibrate combined with UDCA was effective in improving and maintaining biliary enzymes where the ineffectiveness of long-term treatment with UDCA was confirmed. Conclusion: This multicenter, randomized, open study revealed that combination therapy of bezafibrate and UDCA improved biliary enzymes in non-cirrhotic Japanese patients with PBC refractory to UDCA. Further studies are needed to evaluate whether combination therapy improves histological staging and prognosis.

Original languageEnglish
Pages (from-to)557-564
Number of pages8
JournalHepatology Research
Volume38
Issue number6
DOIs
Publication statusPublished - Jun 2008

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Bezafibrate
Ursodeoxycholic Acid
Biliary Liver Cirrhosis
Multicenter Studies
Prospective Studies
Therapeutics
Cholestasis
Enzymes
Bile Acids and Salts
Bile
Phospholipids

Keywords

  • Bezafibrate
  • Primary biliary cirrhosis
  • Ursodeoxycholic acid

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis : A prospective, multicenter study. / Iwasaki, Shinji; Ohira, Hiromasa; Nishiguchi, Shuhei; Zeniya, Mikio; Kaneko, Shuichi; Onji, Morikazu; Ishibashi, Hiromi; Sakaida, Isao; Kuriyama, Shigeki; Ichida, Takafumi; Onishi, Saburo; Toda, Gotaro; Tomita, E.; Shibata, M.; Watanabe, Y.; Iwasaki, Yoshiaki; Hirohara, J.; Nakamura, K.; Kiyosawa, K.; Suzuki, K.; Yasumura, S.

In: Hepatology Research, Vol. 38, No. 6, 06.2008, p. 557-564.

Research output: Contribution to journalArticle

Iwasaki, S, Ohira, H, Nishiguchi, S, Zeniya, M, Kaneko, S, Onji, M, Ishibashi, H, Sakaida, I, Kuriyama, S, Ichida, T, Onishi, S, Toda, G, Tomita, E, Shibata, M, Watanabe, Y, Iwasaki, Y, Hirohara, J, Nakamura, K, Kiyosawa, K, Suzuki, K & Yasumura, S 2008, 'The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis: A prospective, multicenter study', Hepatology Research, vol. 38, no. 6, pp. 557-564. https://doi.org/10.1111/j.1872-034X.2007.00305.x
Iwasaki, Shinji ; Ohira, Hiromasa ; Nishiguchi, Shuhei ; Zeniya, Mikio ; Kaneko, Shuichi ; Onji, Morikazu ; Ishibashi, Hiromi ; Sakaida, Isao ; Kuriyama, Shigeki ; Ichida, Takafumi ; Onishi, Saburo ; Toda, Gotaro ; Tomita, E. ; Shibata, M. ; Watanabe, Y. ; Iwasaki, Yoshiaki ; Hirohara, J. ; Nakamura, K. ; Kiyosawa, K. ; Suzuki, K. ; Yasumura, S. / The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis : A prospective, multicenter study. In: Hepatology Research. 2008 ; Vol. 38, No. 6. pp. 557-564.
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AU - Iwasaki, Shinji

AU - Ohira, Hiromasa

AU - Nishiguchi, Shuhei

AU - Zeniya, Mikio

AU - Kaneko, Shuichi

AU - Onji, Morikazu

AU - Ishibashi, Hiromi

AU - Sakaida, Isao

AU - Kuriyama, Shigeki

AU - Ichida, Takafumi

AU - Onishi, Saburo

AU - Toda, Gotaro

AU - Tomita, E.

AU - Shibata, M.

AU - Watanabe, Y.

AU - Iwasaki, Yoshiaki

AU - Hirohara, J.

AU - Nakamura, K.

AU - Kiyosawa, K.

AU - Suzuki, K.

AU - Yasumura, S.

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N2 - Aim: Treatment with ursodeoxycholic acid (UDCA) improves the survival of stage I and II primary biliary cirrhosis (PBC) patients. However, new therapeutic options are needed for patients who are refractory to UDCA and for those whose disease is at an advanced stage. Bezafibrate could be useful in PBC treatment, since it increases phospholipid output into the bile and reduces the cytotoxicity of hydrophobic bile acids, which are increased with cholestasis. Methods: We conducted two prospective, multicenter randomized open studies in non-cirrhotic patients with PBC to evaluate the efficacy of bezafibrate. One study compared UDCA and bezafibrate monotherapy (study 1: 45 patients [37 females], mean age 55.9 years), and the other evaluated the addition of bezafibrate to patients who were refractory to UDCA (study 2: 21 patients [18 females], mean age 54.1 years). Results: Study 1 demonstrated that bezafibrate monotherapy was as effective as UDCA and study 2 revealed that bezafibrate combined with UDCA was effective in improving and maintaining biliary enzymes where the ineffectiveness of long-term treatment with UDCA was confirmed. Conclusion: This multicenter, randomized, open study revealed that combination therapy of bezafibrate and UDCA improved biliary enzymes in non-cirrhotic Japanese patients with PBC refractory to UDCA. Further studies are needed to evaluate whether combination therapy improves histological staging and prognosis.

AB - Aim: Treatment with ursodeoxycholic acid (UDCA) improves the survival of stage I and II primary biliary cirrhosis (PBC) patients. However, new therapeutic options are needed for patients who are refractory to UDCA and for those whose disease is at an advanced stage. Bezafibrate could be useful in PBC treatment, since it increases phospholipid output into the bile and reduces the cytotoxicity of hydrophobic bile acids, which are increased with cholestasis. Methods: We conducted two prospective, multicenter randomized open studies in non-cirrhotic patients with PBC to evaluate the efficacy of bezafibrate. One study compared UDCA and bezafibrate monotherapy (study 1: 45 patients [37 females], mean age 55.9 years), and the other evaluated the addition of bezafibrate to patients who were refractory to UDCA (study 2: 21 patients [18 females], mean age 54.1 years). Results: Study 1 demonstrated that bezafibrate monotherapy was as effective as UDCA and study 2 revealed that bezafibrate combined with UDCA was effective in improving and maintaining biliary enzymes where the ineffectiveness of long-term treatment with UDCA was confirmed. Conclusion: This multicenter, randomized, open study revealed that combination therapy of bezafibrate and UDCA improved biliary enzymes in non-cirrhotic Japanese patients with PBC refractory to UDCA. Further studies are needed to evaluate whether combination therapy improves histological staging and prognosis.

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