Treatment of primary biliary cirrhosis with ursodeoxycholic acid, budesonide and fibrates

  • Poupon R
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Abstract

Long-term treatment with ursodeoxycholic acid (UDCA; 13-15 mg/kg/day) in patients with primary biliary cirrhosis (PBC) improves biochemical liver tests, delays histological progression and prolongs survival without liver transplantation. UDCA monotherapy appears sufficient for many patients as suggested by long-term observational data. However, the transplant-free survival rate of UDCA-treated patients remains significantly lower than that of an age- and sex-matched control population. Therefore, there is a continued need for new therapeutic options in PBC. In this article we review and discuss the following issues: the appropriate selection of patients requiring new therapeutic options, the role of budesonide in the management of these patients, and the emerging place of peroxisome proliferator-activated receptor-alpha ligands as anti-inflammatory and immunomodulating agents in PBC.

Author-supplied keywords

  • 0 (Fibric Acids)
  • 51333-22-3 (Budesonide)
  • 724L30Y2QR (Ursodeoxycholic Acid)
  • Adult
  • Budesonide/ therapeutic use
  • Female
  • Fibric Acids/ therapeutic use
  • Humans
  • Liver Cirrhosis, Biliary/ drug therapy/pathology
  • Liver/pathology
  • Male
  • Middle Aged
  • Treatment Outcome
  • Ursodeoxycholic Acid/ therapeutic use

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  • R Poupon

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