{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:28:13Z","timestamp":1790263693890,"version":"4.1.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":2922,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2007,9]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>\n                                 <jats:bold>Statin therapy may target both hypercholesterolemia and cholestasis in primary biliary cirrhosis (PBC). However, little is known about the efficacy and safety of statins in PBC. The aim of this single-center study was therefore to prospectively examine the effects of atorvastatin on serum markers of cholestasis, aminotransferases, and lipid and bile acid metabolism as well as inflammatory and immunological markers in patients with PBC. Fifteen patients with early-stage PBC and an incomplete biochemical response to ursodeoxycholic acid (UDCA) therapy (defined as alkaline phosphatase 1.5-fold above the upper limit of normal after 1 year) were treated with atorvastatin 10 mg\/day, 20 mg\/day, and 40 mg\/day for 4 weeks, respectively. Serum levels of alkaline phosphatase increased during atorvastatin 20 mg and 40 mg (<\/jats:bold>\n                                 <jats:bold>\n                                    P\n                                 <\/jats:bold>\n                                 <jats:bold>&lt; 0.05), whereas leucine aminopeptidase and \u03b3-glutamyltransferase remained unchanged. No statistical differences in overall serum ALT, AST, bilirubin, and IgM levels were observed. However, atorvastatin was discontinued in 1 out of 15 patients because of ALT 2-fold above baseline, and 2 patients showed ALT elevations 3-fold above the upper limit of normal at the end of the atorvastatin treatment period. Serum total cholesterol and low-density lipoprotein cholesterol levels decreased by 35% and 49%, respectively (<\/jats:bold>\n                                 <jats:bold>\n                                    P\n                                 <\/jats:bold>\n                                 <jats:bold>&lt; 0.001). Precursors of cholesterol biosynthesis (lanosterol, desmosterol, lathosterol) showed a similar pattern. No changes in serum bile acid levels and composition were observed during treatment.<\/jats:bold>\n                                 <jats:bold>\n                                    Conclusion:\n                                 <\/jats:bold>\n                                 <jats:bold>Atorvastatin does not improve cholestasis in PBC patients with an incomplete biochemical response to UDCA but effectively reduces serum cholesterol levels. (Hepatology 2007.)<\/jats:bold>\n                              <\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.21741","type":"journal-article","created":{"date-parts":[[2007,8,1]],"date-time":"2007-08-01T23:18:49Z","timestamp":1186010329000},"page":"776-784","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":77,"title":["Atorvastatin in patients with primary biliary cirrhosis and incomplete biochemical response to ursodeoxycholic acid"],"prefix":"10.1097","volume":"46","author":[{"given":"Tatjana","family":"Stojakovic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csilla","family":"Putz-Bankuti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcnter","family":"Fauler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Scharnagl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Stadlbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Gurakuqi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf E.","family":"Stauber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried","family":"M\u00e4rz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-22-20241201","doi-asserted-by":"crossref","first-page":"12611273","DOI":"10.1056\/NEJMra043898","article-title":"Primary biliary cirrhosis.","volume":"353","author":"Kaplan","year":"2005","journal-title":"N Engl J Med"},{"key":"R2-22-20241201","doi-asserted-by":"crossref","first-page":"216231","DOI":"10.1097\/00001574-200305000-00005","article-title":"Cholestatic syndromes.","volume":"19","author":"Trauner","year":"2003","journal-title":"Curr Opin Gastroenterol"},{"issue":"Suppl 1","key":"R3-22-20241201","first-page":"S24S37","article-title":"Current management of primary biliary cirrhosis and primary sclerosing cholangitis.","volume":"38","author":"Levy","year":"2003","journal-title":"J Hepatol"},{"key":"R4-22-20241201","doi-asserted-by":"crossref","first-page":"6781","DOI":"10.1016\/S1089-3261(03)00135-1","article-title":"Mechanisms of action and therapeutic efficacy of ursodeoxycholic acid in cholestatic liver disease.","volume":"8","author":"Paumgartner","year":"2004","journal-title":"Clin Liver Dis"},{"key":"R5-22-20241201","doi-asserted-by":"crossref","first-page":"715720","DOI":"10.1053\/j.gastro.2005.12.029","article-title":"Excellent longterm survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic Acid.","volume":"130","author":"Pares","year":"2006","journal-title":"Gastroenterology"},{"key":"R6-22-20241201","doi-asserted-by":"crossref","first-page":"121126","DOI":"10.1136\/gut.46.1.121","article-title":"Characterisation of patients with primary biliary cirrhosis responding to long term ursodeoxycholic acid treatment.","volume":"46","author":"Leuschner","year":"2000","journal-title":"Gut"},{"key":"R7-22-20241201","first-page":"8995","article-title":"Metabolism of cholesterol and low and highdensity lipoproteins in primary biliary cirrhosis: cholesterol absorption and synthesis related to lipoprotein levels and their kinetics.","volume":"21","author":"Gylling","year":"1995","journal-title":"HEPATOLOGY"},{"key":"R8-22-20241201","first-page":"12661278","article-title":"Lipoprotein abnormalities in primary biliary cirrhosis. 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