{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:40:55Z","timestamp":1789656055015,"version":"4.0.1"},"reference-count":92,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"am","delay-in-days":352,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016915","name":"Inventiva Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016915","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cghjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2021,11]]},"DOI":"10.1016\/j.cgh.2020.06.062","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T20:42:20Z","timestamp":1593808940000},"page":"2241-2251.e1","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":35,"title":["Definition and Management of Patients With Primary Biliary Cholangitis and an Incomplete Response to Therapy"],"prefix":"10.1016","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2511-7980","authenticated-orcid":false,"given":"Aldo J.","family":"Montano-Loza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Corpechot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.cgh.2020.06.062_bib1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jhep.2017.03.022","article-title":"EASL clinical practice guidelines: the diagnosis and management of patients with primary biliary cholangitis","volume":"67","year":"2017","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib2","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1002\/hep.30145","article-title":"Primary biliary cholangitis: 2018 practice guidance from the American Association for the Study of Liver Diseases","volume":"69","author":"Lindor","year":"2019","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib3","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1002\/hep.24691","article-title":"A\u00a0biliary HCO3- umbrella constitutes a protective mechanism against bile acid-induced injury in human cholangiocytes","volume":"55","author":"Hohenester","year":"2012","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib4","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1002\/hep.29533","article-title":"MicroRNA-506 promotes primary biliary cholangitis-like features in cholangiocytes and immune activation","volume":"67","author":"Erice","year":"2018","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib5","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/hep.25691","article-title":"Up-regulation of microRNA 506 leads to decreased Cl-\/HCO3- anion exchanger 2 expression in biliary epithelium of patients with primary biliary cirrhosis","volume":"56","author":"Banales","year":"2012","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib6","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1016\/S0140-6736(96)04410-8","article-title":"Natural history of early primary biliary cirrhosis","volume":"348","author":"Metcalf","year":"1996","journal-title":"Lancet"},{"key":"10.1016\/j.cgh.2020.06.062_bib7","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1002\/hep.28859","article-title":"Large-scale characterization study of patients with antimitochondrial antibodies but nonestablished primary biliary cholangitis","volume":"65","author":"Dahlqvist","year":"2017","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib8","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1053\/gast.2002.36027","article-title":"Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis: follow-up for up to 28 years","volume":"123","author":"Prince","year":"2002","journal-title":"Gastroenterology"},{"issue":"Suppl","key":"10.1016\/j.cgh.2020.06.062_bib9","doi-asserted-by":"crossref","first-page":"S25","DOI":"10.1016\/j.jhep.2015.02.023","article-title":"New paradigms in the treatment of hepatic cholestasis: from UDCA to FXR, PXR and beyond","volume":"62","author":"Beuers","year":"2015","journal-title":"J\u00a0Hepatol"},{"issue":"Suppl 1","key":"10.1016\/j.cgh.2020.06.062_bib10","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/S2210-7401(12)70015-3","article-title":"Ursodeoxycholic acid and bile-acid mimetics as therapeutic agents for cholestatic liver diseases: an overview of their mechanisms of action","volume":"36","author":"Poupon","year":"2012","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib11","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1046\/j.1365-2036.2003.01792.x","article-title":"Systematic review: ursodeoxycholic acid--adverse effects and drug interactions","volume":"18","author":"Hempfling","year":"2003","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1016\/j.cgh.2020.06.062_bib12","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1056\/NEJM199105303242204","article-title":"A\u00a0multicenter, controlled trial of ursodiol for the treatment of primary biliary cirrhosis. UDCA-PBC Study Group","volume":"324","author":"Poupon","year":"1991","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.cgh.2020.06.062_bib13","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1002\/hep.1840190512","article-title":"The Canadian Multicenter Double-blind Randomized Controlled Trial of ursodeoxycholic acid in primary biliary cirrhosis","volume":"19","author":"Heathcote","year":"1994","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib14","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/0016-5085(94)90021-3","article-title":"Ursodeoxycholic acid in the treatment of primary biliary cirrhosis","volume":"106","author":"Lindor","year":"1994","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib15","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1002\/hep.510290301","article-title":"Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis","volume":"29","author":"Angulo","year":"1999","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib16","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/S0168-8278(00)80216-0","article-title":"Long-term effects of ursodeoxycholic acid in primary biliary cirrhosis: results of a double-blind controlled multicentric trial. UDCA-Cooperative Group from the Spanish Association for the Study of the Liver","volume":"32","author":"Pares","year":"2000","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib17","first-page":"CD000551","article-title":"Ursodeoxycholic acid for primary biliary cirrhosis","volume":"12","author":"Rudic","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.cgh.2020.06.062_bib18","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1053\/j.gastro.2005.12.029","article-title":"Excellent long-term survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic acid","volume":"130","author":"Pares","year":"2006","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib19","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/S0016-5085(97)70183-5","article-title":"Combined analysis of randomized controlled trials of ursodeoxycholic acid in primary biliary cirrhosis","volume":"113","author":"Poupon","year":"1997","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib20","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1053\/j.gastro.2004.11.009","article-title":"The effect of ursodeoxycholic acid therapy on the natural course of primary biliary cirrhosis","volume":"128","author":"Corpechot","year":"2005","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib21","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1002\/hep.22428","article-title":"Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis","volume":"48","author":"Corpechot","year":"2008","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib22","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1053\/j.gastro.2009.01.003","article-title":"Improved prognosis of patients with primary biliary cirrhosis that have a biochemical response to ursodeoxycholic acid","volume":"136","author":"Kuiper","year":"2009","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib23","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1016\/j.cgh.2007.07.015","article-title":"Transplantation trends in primary biliary cirrhosis","volume":"5","author":"Lee","year":"2007","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib24","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1186\/1471-230X-10-144","article-title":"Trends in liver transplantation for primary biliary cirrhosis in the Netherlands 1988-2008","volume":"10","author":"Kuiper","year":"2010","journal-title":"BMC Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib25","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.jhep.2019.04.001","article-title":"Ursodeoxycholic acid therapy and liver transplant-free survival in patients with primary biliary cholangitis","volume":"71","author":"Harms","year":"2019","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib26","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/j.1478-3231.1999.tb00020.x","article-title":"Utilization of the Mayo risk score in patients with primary biliary cirrhosis receiving ursodeoxycholic acid","volume":"19","author":"Angulo","year":"1999","journal-title":"Liver"},{"key":"10.1016\/j.cgh.2020.06.062_bib27","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1038\/ajg.2010.216","article-title":"Baseline ductopenia and treatment response predict long-term histological progression in primary biliary cirrhosis","volume":"105","author":"Kumagi","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib28","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/j.jhep.2011.02.031","article-title":"Early primary biliary cirrhosis: biochemical response to treatment and prediction of long-term outcome","volume":"55","author":"Corpechot","year":"2011","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib29","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1007\/s00535-009-0051-9","article-title":"Early biochemical response to ursodeoxycholic acid predicts symptom development in patients with asymptomatic primary biliary cirrhosis","volume":"44","author":"Azemoto","year":"2009","journal-title":"J\u00a0Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib30","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1002\/hep.28017","article-title":"The UK-PBC risk scores: derivation and validation of a scoring system for long-term prediction of end-stage liver disease in primary biliary cholangitis","volume":"63","author":"Carbone","year":"2016","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib31","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1053\/j.gastro.2015.07.061","article-title":"Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy","volume":"149","author":"Lammers","year":"2015","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib32","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1053\/j.gastro.2014.08.029","article-title":"Levels of alkaline phosphatase and bilirubin are surrogate end points of outcomes of patients with primary biliary cirrhosis: an international follow-up study","volume":"147","author":"Lammers","year":"2014","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib33","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.14309\/ajg.0000000000000557","article-title":"Goals of treatment for improved survival in primary biliary cholangitis: treatment target should be bilirubin within the normal range and normalization of alkaline phosphatase","volume":"115","author":"Murillo Perez","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib34","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.14309\/ajg.0000000000000290","article-title":"Validation of risk scoring systems in ursodeoxycholic acid-treated patients with primary biliary cholangitis","volume":"114","author":"Efe","year":"2019","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib35","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1056\/NEJMoa1509840","article-title":"A\u00a0placebo-controlled trial of obeticholic acid in primary biliary cholangitis","volume":"375","author":"Nevens","year":"2016","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.cgh.2020.06.062_bib36","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1056\/NEJMoa1714519","article-title":"A\u00a0placebo-controlled trial of bezafibrate in primary biliary cholangitis","volume":"378","author":"Corpechot","year":"2018","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.cgh.2020.06.062_bib37","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/S0168-8278(99)80136-6","article-title":"Comparison of three doses of ursodeoxycholic acid in the treatment of primary biliary cirrhosis: a randomized trial","volume":"30","author":"Angulo","year":"1999","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib38","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.clinre.2018.08.006","article-title":"Adherence to ursodeoxycholic acid therapy in patients with cholestatic and autoimmune liver disease","volume":"43","author":"Leoni","year":"2019","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib39","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/hep.510280203","article-title":"Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: clinical features and response to therapy","volume":"28","author":"Chazouilleres","year":"1998","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib40","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.ejim.2008.12.011","article-title":"Transitions between variant forms of primary biliary cirrhosis during long-term follow-up","volume":"20","author":"Lindgren","year":"2009","journal-title":"Eur J Intern Med"},{"key":"10.1016\/j.cgh.2020.06.062_bib41","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.jhep.2010.09.002","article-title":"Overlap syndromes: the International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue","volume":"54","author":"Boberg","year":"2011","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib42","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s12016-015-8516-5","article-title":"The natural history and prognosis of primary biliary cirrhosis with clinical features of autoimmune hepatitis","volume":"50","author":"Yang","year":"2016","journal-title":"Clin Rev Allergy Immunol"},{"key":"10.1016\/j.cgh.2020.06.062_bib43","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.cgh.2013.09.021","article-title":"Factors associated with response to therapy and outcome of patients with primary biliary cirrhosis with features of autoimmune hepatitis","volume":"12","author":"Ozaslan","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib44","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jhep.2005.10.017","article-title":"Long term outcome and response to therapy of primary biliary cirrhosis-autoimmune hepatitis overlap syndrome","volume":"44","author":"Chazouilleres","year":"2006","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib45","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1089\/thy.2007.0189","article-title":"Serial changes in liver\u00a0function tests in patients with thyrotoxicosis induced by Graves' disease and painless thyroiditis","volume":"18","author":"Kubota","year":"2008","journal-title":"Thyroid"},{"key":"10.1016\/j.cgh.2020.06.062_bib46","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2147\/CEG.S7556","article-title":"Hepatic manifestations of celiac disease","volume":"3","author":"Freeman","year":"2010","journal-title":"Clin Exp Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib47","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/01.MP.0000042420.21088.C7","article-title":"Concurrence of histologic features of steatohepatitis with other forms of chronic liver disease","volume":"16","author":"Brunt","year":"2003","journal-title":"Mod Pathol"},{"key":"10.1016\/j.cgh.2020.06.062_bib48","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1097\/MCG.0b013e318261e659","article-title":"Primary biliary cirrhosis is more severe in overweight patients","volume":"47","author":"Hindi","year":"2013","journal-title":"J\u00a0Clin Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib49","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1136\/gutjnl-2019-319057","article-title":"Number needed to treat with ursodeoxycholic acid therapy to prevent liver transplantation or death in primary biliary cholangitis","volume":"69","author":"Harms","year":"2020","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2020.06.062_bib50","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/S2468-1253(18)30163-8","article-title":"Pretreatment prediction of response to ursodeoxycholic acid in primary biliary cholangitis: development and validation of the UDCA Response Score","volume":"3","author":"Carbone","year":"2018","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib51","doi-asserted-by":"crossref","first-page":"3569","DOI":"10.1021\/jm025529g","article-title":"6alpha-ethyl-chenodeoxycholic acid (6-ECDCA), a potent and selective FXR agonist endowed with anticholestatic activity","volume":"45","author":"Pellicciari","year":"2002","journal-title":"J\u00a0Med Chem"},{"key":"10.1016\/j.cgh.2020.06.062_bib52","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1002\/hep.22519","article-title":"Farnesoid X receptor antagonizes nuclear factor kappaB in hepatic inflammatory response","volume":"48","author":"Wang","year":"2008","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib53","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/S2468-1253(19)30094-9","article-title":"Long-term efficacy and safety of obeticholic acid for patients with primary biliary cholangitis: 3-year results of an international open-label extension study","volume":"4","author":"Trauner","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib54","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.cgh.2019.09.050","article-title":"Long-term obeticholic acid therapy improves histological endpoints in patients with primary biliary cholangitis","volume":"18","author":"Bowlus","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib55","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1002\/hep.31017","article-title":"Liver injury in patients with cholestatic liver disease treated with obeticholic acid","volume":"71","author":"Eaton","year":"2020","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib56","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1021\/jm990554g","article-title":"The PPARs: from orphan receptors to drug discovery","volume":"43","author":"Willson","year":"2000","journal-title":"J\u00a0Med Chem"},{"key":"10.1016\/j.cgh.2020.06.062_bib57","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/0026-0495(93)90056-T","article-title":"The effect of bezafibrate treatment on serum alkaline phosphatase isoenzyme activities","volume":"42","author":"Day","year":"1993","journal-title":"Metabolism"},{"key":"10.1016\/j.cgh.2020.06.062_bib58","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/S1386-6346(99)00033-9","article-title":"Bezafibrate may have a beneficial effect in pre-cirrhotic primary biliary cirrhosis","volume":"16","author":"Iwasaki","year":"1999","journal-title":"Hepatol Res"},{"key":"10.1016\/j.cgh.2020.06.062_bib59","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1161\/hq1101.098228","article-title":"Fibrates suppress bile acid synthesis via peroxisome proliferator-activated receptor-alpha-mediated downregulation of cholesterol 7alpha-hydroxylase and sterol 27-hydroxylase expression","volume":"21","author":"Post","year":"2001","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"10.1016\/j.cgh.2020.06.062_bib60","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1042\/bj3140781","article-title":"Fibrates induce mdr2 gene expression and biliary phospholipid secretion in the mouse","volume":"314","author":"Chianale","year":"1996","journal-title":"Biochem J"},{"issue":"Suppl","key":"10.1016\/j.cgh.2020.06.062_bib61","first-page":"9A","article-title":"Bezafibrate is more effective than placebo in pruritus of chronic cholestasis: the Fitch trial","volume":"70","author":"de Vries","year":"2019","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib62","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1111\/apt.13465","article-title":"Combined ursodeoxycholic acid (UDCA) and fenofibrate in primary biliary cholangitis patients with incomplete UDCA response may improve outcomes","volume":"43","author":"Cheung","year":"2016","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1016\/j.cgh.2020.06.062_bib63","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.2337\/dc11-1811","article-title":"Reversibility of fenofibrate therapy-induced renal function impairment in ACCORD type 2 diabetic participants","volume":"35","author":"Mychaleckyj","year":"2012","journal-title":"Diabetes Care"},{"key":"10.1016\/j.cgh.2020.06.062_bib64","doi-asserted-by":"crossref","first-page":"3596","DOI":"10.1007\/s10620-017-4812-7","article-title":"Identification and characterization of fenofibrate-induced liver injury","volume":"62","author":"Ahmad","year":"2017","journal-title":"Dig Dis Sci"},{"key":"10.1016\/j.cgh.2020.06.062_bib65","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/apt.15049","article-title":"Letter: reduction in projected mortality or need for liver transplantation associated with bezafibrate add-on in primary biliary cholangitis with incomplete UDCA response","volume":"49","author":"Corpechot","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1016\/j.cgh.2020.06.062_bib66","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1016\/j.jhep.2019.12.027","article-title":"Switching vs. add-on strategy in PBC treatment: lessons from UDCA and bezafibrate experience","volume":"72","author":"Corpechot","year":"2020","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib67","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1002\/hep.30552","article-title":"Bezafibrate improves GLOBE and UK-PBC scores and long-term outcomes in patients with primary biliary cholangitis","volume":"70","author":"Honda","year":"2019","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib68","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.clinre.2015.02.011","article-title":"Fenofibrate is effective adjunctive therapy in the treatment of primary biliary cirrhosis: a meta-analysis","volume":"39","author":"Grigorian","year":"2015","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib69","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/S0016-5085(99)70351-3","article-title":"Oral budesonide and ursodeoxycholic acid for treatment of primary biliary cirrhosis: results of a prospective double-blind trial","volume":"117","author":"Leuschner","year":"1999","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib70","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1002\/hep.20646","article-title":"Budesonide combined with UDCA to improve liver histology in primary biliary cirrhosis: a three-year randomized trial","volume":"41","author":"Rautiainen","year":"2005","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib71","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1053\/jhep.2003.50266","article-title":"Pharmacokinetics and pharmacodynamic action of budesonide in early- and late-stage primary biliary cirrhosis","volume":"38","author":"Hempfling","year":"2003","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib72","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1016\/S0168-8278(18)30293-9","article-title":"Results of a randomised controlled trial of budesonide add-on therapy in patients with primary biliary cholangitis and an incomplete response to ursodeoxycholic acid","volume":"68","author":"Hirschfield","year":"2018","journal-title":"J\u00a0Hepatol"},{"issue":"Suppl","key":"10.1016\/j.cgh.2020.06.062_bib73","doi-asserted-by":"crossref","first-page":"e130","DOI":"10.1016\/S0618-8278(19)30229-4","article-title":"Bezafibrate improves the effect of obeticholic acid on cholestasis in patients with primary biliary cholangitis","volume":"70","author":"Smets","year":"2019","journal-title":"J\u00a0Hepatol"},{"issue":"Suppl 1","key":"10.1016\/j.cgh.2020.06.062_bib74","first-page":"LP6","article-title":"Additive beneficial effects of fibrates combined with obeticholic acid in the treatment of patients with primary biliary cholangitis and inadequate response to second-line therapy","volume":"70","author":"Soret","year":"2019","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib75","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1053\/j.gastro.2018.10.001","article-title":"Factors associated with recurrence of primary biliary cholangitis after liver transplantation and effects on graft and patient survival","volume":"156","author":"Montano-Loza","year":"2019","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib76","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1136\/gut.20.2.137","article-title":"Serum bilirubin: a prognostic factor in primary biliary cirrhosis","volume":"20","author":"Shapiro","year":"1979","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2020.06.062_bib77","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1111\/j.1478-3231.2011.02678.x","article-title":"Optimizing biochemical markers as endpoints for clinical trials in primary biliary cirrhosis","volume":"32","author":"Momah","year":"2012","journal-title":"Liver Int"},{"key":"10.1016\/j.cgh.2020.06.062_bib78","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1053\/j.gastro.2012.12.005","article-title":"Sex and age are determinants of the clinical phenotype of primary biliary cirrhosis and response to ursodeoxycholic acid","volume":"144","author":"Carbone","year":"2013","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib79","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1136\/gutjnl-2014-308351","article-title":"Stratification of hepatocellular carcinoma risk in primary biliary cirrhosis: a multicentre international study","volume":"65","author":"Trivedi","year":"2016","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2020.06.062_bib80","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1053\/gast.2002.36027","article-title":"Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis: follow-up for up to 28 years","volume":"123","author":"Prince","year":"2002","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2020.06.062_bib81","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1136\/gut.2003.023937","article-title":"Asymptomatic primary biliary cirrhosis: clinical features, prognosis, and symptom progression in a large population based cohort","volume":"53","author":"Prince","year":"2004","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2020.06.062_bib82","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1111\/liv.12560","article-title":"Fatigue and pruritus at onset identify a more aggressive subset of primary biliary cirrhosis","volume":"35","author":"Quarneti","year":"2015","journal-title":"Liver Int"},{"key":"10.1016\/j.cgh.2020.06.062_bib83","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/j.1572-0241.2003.07257.x","article-title":"Characterization and clinical impact of antinuclear antibodies in primary biliary cirrhosis","volume":"98","author":"Muratori","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib84","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1136\/gut.2003.036558","article-title":"Prevalence and clinical significance of isotype specific antinuclear antibodies in primary biliary cirrhosis","volume":"54","author":"Rigopoulou","year":"2005","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2020.06.062_bib85","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1002\/hep.21172","article-title":"Correlation of initial autoantibody profile and clinical outcome in primary biliary cirrhosis","volume":"43","author":"Wesierska-Gadek","year":"2006","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib86","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1016\/j.jhep.2014.01.029","article-title":"Optimising risk stratification in primary biliary cirrhosis: AST\/platelet ratio index predicts outcome independent of ursodeoxycholic acid response","volume":"60","author":"Trivedi","year":"2014","journal-title":"J\u00a0Hepatol"},{"key":"10.1016\/j.cgh.2020.06.062_bib87","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1002\/hep.22517","article-title":"Prediction of clinical outcomes in primary biliary cirrhosis by serum enhanced liver fibrosis assay","volume":"48","author":"Mayo","year":"2008","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib88","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1002\/hep.25599","article-title":"Noninvasive elastography-based assessment of liver fibrosis progression and prognosis in primary biliary cirrhosis","volume":"56","author":"Corpechot","year":"2012","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib89","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1002\/hep.510290603","article-title":"Ten-year survival in ursodeoxycholic acid-treated patients with primary biliary cirrhosis. The UDCA-PBC Study Group","volume":"29","author":"Poupon","year":"1999","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2020.06.062_bib90","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1056\/NEJM198301063080101","article-title":"The prognostic importance of clinical and histologic features in asymptomatic and symptomatic primary biliary cirrhosis","volume":"308","author":"Roll","year":"1983","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.cgh.2020.06.062_bib91","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.14309\/ajg.0000000000000557","article-title":"Goals of treatment for improved survival in primary biliary cholangitis: treatment target should be bilirubin within the normal range and normalization of alkaline phosphatase","volume":"115","author":"Murillo Perez","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2020.06.062_bib92","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1053\/j.gastro.2008.07.019","article-title":"Portal hypertension and primary biliary cirrhosis: effect of long-term ursodeoxycholic acid treatment","volume":"135","author":"Huet","year":"2008","journal-title":"Gastroenterology"}],"container-title":["Clinical Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356520309265?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356520309265?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T05:35:10Z","timestamp":1761543310000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1542356520309265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":92,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["S1542356520309265"],"URL":"https:\/\/doi.org\/10.1016\/j.cgh.2020.06.062","relation":{},"ISSN":["1542-3565"],"issn-type":[{"value":"1542-3565","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Definition and Management of Patients With Primary Biliary Cholangitis and an Incomplete Response to Therapy","name":"articletitle","label":"Article Title"},{"value":"Clinical Gastroenterology and Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.cgh.2020.06.062","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 by the AGA Institute","name":"copyright","label":"Copyright"}]}}