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Since potential favourable effects of fibrates have been reported in short series with inconclusive results, we have carried out a pilot study to analyse the effects of bezafibrate in patients with suboptimal response to <jats:styled-content style=\"fixed-case\">UDCA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty women (age 52.3\u00a0\u00b1\u00a02.3\u00a0years) treated with <jats:styled-content style=\"fixed-case\">UDCA<\/jats:styled-content> and abnormal alkaline phosphatase (<jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content>) levels received bezafibrate (400\u00a0mg\/d) for 1\u00a0year. Changes were measured every 3\u00a0months during the study period of 12\u00a0months, 3\u00a0months after discontinuation and 3\u00a0months after resuming bezafibrate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two patients discontinued the treatment after few days, three at 6 and one at 9\u00a0months. Bezafibrate treatment resulted in a significant decrease in <jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content> as early as 3\u00a0months. Normalization or decrease of <jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content> below 1.5\u00a0times normal levels was observed in 13 and 4 patients respectively. There was also a significant decrease in \u03b3\u2010glutamyl transferase and alanine aminotransferase, cholesterol and triglyceride levels. Bezafibrate treatment resulted in significant improvement of pruritus. A rebound in liver biochemistries and pruritus occurred upon drug discontinuation, changes which improved again after resuming bezafibrate. Response to bezafibrate was associated with lower liver stiffness and severity of cholestasis. No severe adverse effects were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Combination treatment of bezafibrate and <jats:styled-content style=\"fixed-case\">UDCA<\/jats:styled-content> is associated with marked decrease or normalization of alkaline phosphatase as early as 3\u00a0months in patients with <jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>. Better biochemical response was observed in patients with early disease and lower cholestasis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12290","type":"journal-article","created":{"date-parts":[[2013,7,31]],"date-time":"2013-07-31T09:02:14Z","timestamp":1375261334000},"page":"197-203","source":"Crossref","is-referenced-by-count":90,"title":["Bezafibrate normalizes alkaline phosphatase in primary biliary cirrhosis patients with incomplete response to ursodeoxycholic acid"],"prefix":"10.1111","volume":"34","author":[{"given":"Sabela","family":"Lens","sequence":"first","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, CIBERehd University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Leoz","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, CIBERehd University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyla","family":"Nazal","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, CIBERehd University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Bruguera","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, CIBERehd University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Par\u00e9s","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital Cl\u00ednic, IDIBAPS, CIBERehd University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,9,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.04.009"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22906"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.12.029"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22428"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.01.003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(99)70351-3"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510310209"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2001.01018.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20897"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2000.18663"},{"key":"e_1_2_7_12_1","first-page":"357A","article-title":"Farnesoid\u2010X receptor agonists: a new class of drugs for the treatment of PBC? 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