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Factors predictive of the efficacy of bezafibrate therapy in patients with primary sclerosing cholangitis
Author(s) -
Mizuno Suguru,
Isayama Hiroyuki,
Hirano Kenji,
Watanabe Takeo,
Takahara Naminatsu,
Kogure Hirofumi,
Matsubara Saburo,
Nakai Yousuke,
Tada Minoru,
Koike Kazuhiko
Publication year - 2017
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12846
Subject(s) - bezafibrate , primary sclerosing cholangitis , medicine , gastroenterology , disease
Aim Primary sclerosing cholangitis (PSC) is a rare cholestatic disease. We previously reported the effects of bezafibrate on elevated hepatobiliary enzyme levels in patients with this disease both retrospectively and prospectively. In this study, we assessed factors predictive of bezafibrate efficacy. Methods Twenty‐five patients with PSC, who underwent bezafibrate therapy (400 mg per day) from November 2006 to June 2015, were evaluated. Treatment was judged as being effective if the levels of all of the hepatobiliary enzymes decreased after 12 weeks. We investigated the patients’ characteristics, disease history, concomitant medications, liver function, and liver stiffness. Results The efficacy rate of bezafibrate was 60% (15/25 patients). The efficacy rate in patients graded as Child–Pugh class A was significantly higher (75% [15/20]) than that in patients graded as class B (0% [0/5], P < 0.01). Non‐responders had higher liver stiffness values (18.0 vs. 8.8 kPa, P = 0.19), and concomitantly used ursodeoxycholic acid more frequently (100% vs. 73%, P = 0.12) than responders. Conclusions We could not elucidate the factors predictive for bezafibrate efficacy for the treatment of PSC. However, bezafibrate was more effective for patients with preserved liver function (Child–Pugh class A) when it was prescribed before progression of liver fibrosis and failure of ursodeoxycholic acid therapy.