{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:26:10Z","timestamp":1789244770569,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We aimed to evaluate the effect of pemafibrate, a selective peroxisome proliferator\u2010activated receptor\u2010\u03b1 modulator, on patients with primary biliary cholangitis (PBC) complicated by dyslipidemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 61 patients with PBC (Add\u2010on group: 33 patients on ursodeoxycholic acid [UDCA]\u00a0+\u00a0pemafibrate combination therapy; Switch group: 28 patients who switched from UDCA\u00a0+\u00a0other fibrates to UDCA\u00a0+\u00a0pemafibrate combination therapy) were included in the study. Changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma\u2010glutamyl transferase (GGT), alkaline phosphatase (ALP), and GLOBE scores were retrospectively analyzed from 6\u00a0months before to 12\u00a0months after treatment. The POISE criteria were also used to evaluate the treatment efficacy after 12\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 12\u00a0months of UDCA\u00a0+\u00a0pemafibrate combination therapy, AST significantly decreased from 45\u00a0\u00b1\u00a03 to 28\u00a0\u00b1\u00a03 U\/L (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05), ALT from 49\u00a0\u00b1\u00a05 to 32\u00a0\u00b1\u00a05 U\/L (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.005), GGT from 155\u00a0\u00b1\u00a0223 to 91\u00a0\u00b1\u00a0182 U\/L (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.005), and ALP from 1.4\u00a0\u00b1\u00a00.9 to 0.9\u00a0\u00b1\u00a00.8 \u00d7 upper limit of normal (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0005) in all patients. ALT, GGT, and ALP levels were significantly lower after 12\u00a0months of UDCA\u00a0+\u00a0pemafibrate combination therapy in both the Add\u2010on and Switch groups. After 12\u00a0months of combination therapy, the mean GLOBE score of all patients significantly decreased from 0.37 to 0.01 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05) and the percentage of patients with a GLOBE score of 0.3 or higher decreased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with PBC who showed an inadequate response to prior therapy, pemafibrate add\u2010on or switch therapy improved liver biochemistry and GLOBE scores. Pemafibrate may be useful as a second\u2010line drug when UDCA alone is inadequate, or as an alternative after combination therapy with other fibrates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.14172","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T15:54:17Z","timestamp":1739980457000},"page":"675-684","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pemafibrate improves liver biochemistry and GLOBE scores in patients with primary biliary cholangitis: Nationwide, multicenter study by the Japanese Red Cross Liver Study Group"],"prefix":"10.1111","volume":"55","author":[{"given":"Keiji","family":"Tsuji","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Hiroshima Red Cross Hospital and Atomic\u2010bomb Survivors Hospital  Hiroshima 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