{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:12:18Z","timestamp":1780467138922,"version":"3.54.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Fenofibrate (FF) has shown potential benefits in patients with primary biliary cholangitis (PBC) who have an incomplete response to ursodeoxycholic acid (UDCA). However, the efficacy and safety of FF in patients with cirrhosis remain unclear. To evaluate the efficacy and safety of additional FF therapy in patients with PBC\u2010related cirrhosis with an incomplete response to UDCA, we conducted a retrospective analysis comparing the clinical results of additional FF therapy and continued UDCA monotherapy. A total of 59 patients were included; 27 cases underwent UDCA monotherapy and 32 cases underwent UDCA combined with FF therapy. A significant difference in alkaline phosphatase (ALP) normalization was achieved in the FF group compared to the UDCA group (37% vs. 11%, respectively; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.020). Additional FF therapy was an independent risk factor for ALP normalization (hazard ratio, 7.679; 95% confidence interval, 2.059\u201328.633; <jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.003). Hepatic deterioration was experienced by 40% versus 48% (<jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.562) while 11% vs. 37% (<jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.111) experienced liver\u2010related mortality or liver transplantation in the FF and UDCA groups, respectively. Compared to UDCA monotherapy, additional FF therapy was associated with lower United Kingdom (UK)\u2010PBC risk score and surrogate serum indices of liver fibrosis. After 12\u2009months of add\u2010on FF therapy, median ALP level and UK\u2010PBC risk score decreased 35% and 52% from baseline (<jats:italic toggle=\"yes\">p<\/jats:italic>\u00a0=\u00a00.001 and 0.210, respectively). Serum aminotransferase, triglyceride, and cholesterol decreased progressively, while total bilirubin, serum creatinine, blood urea, estimated glomerular filtration rate, aspartate aminotransferase\u2010to\u2010platelet ratio index, and fibrosis\u20104 index remained stable in FF\u2010treated cirrhotic cases during follow\u2010up. No significant adverse effects associated with additional FF therapy were observed in our cohort. <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: Additional FF therapy was associated with higher ALP normalization rates and lower UK\u2010PBC risk scores in patients with cirrhotic PBC with an incomplete response to UDCA. In addition, FF therapy seemed safe and well tolerated with a low frequency of adverse effects in patients with cirrhosis.<\/jats:p>","DOI":"10.1002\/hep4.2103","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T12:57:03Z","timestamp":1665406623000},"page":"3487-3495","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":23,"title":["Efficacy and safety of fenofibrate addition therapy in patients with cirrhotic primary biliary cholangitis with incomplete response to ursodeoxycholic acid"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0201-5081","authenticated-orcid":false,"given":"Dawei","family":"Ding","sequence":"first","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanya","family":"Guo","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yansheng","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linhua","family":"Zheng","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui","family":"Jia","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Deng","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiqing","family":"Sun","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiufang","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changcun","family":"Guo","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8576-3175","authenticated-orcid":false,"given":"Yulong","family":"Shang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3046-9507","authenticated-orcid":false,"given":"Ying","family":"Han","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases, The Air Force Military Medical University,Xi'an,China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"issue":"10003","key":"hep42103-bib-0001-20241116","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1016\/S0140-6736(15)00154-3","article-title":"Primary biliary cirrhosis","volume":"386","year":"2015","journal-title":"Lancet"},{"issue":"1","key":"hep42103-bib-0002-20241116","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/hep.22906","article-title":"Primary biliary cirrhosis","volume":"50","year":"2009","journal-title":"Hepatology"},{"issue":"19","key":"hep42103-bib-0003-20241116","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1056\/NEJM199405123301903","article-title":"Ursodiol for the long\u2010term treatment of primary biliary cirrhosis. 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