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Efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: A retrospective study and updated meta-analysis

Background: Ursodeoxycholic acid (UDCA) is currently used for the treatment of primary biliary cholangitis (PBC), but some people do not respond well to UDCA. It reported that the combination of fenofibrate and UDCA can improve the clinical indices in these patients. However, more high-quality evide...

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Autores principales: Guoyun, Xuan, Dawei, Ding, Ning, Liu, Yinan, Hu, Fangfang, Yang, Siyuan, Tian, Hao, Sun, Jiaqi, Yang, Ang, Xu, Guanya, Guo, Xi, Chen, Yulong, Shang, Ying, Han
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468667/
https://www.ncbi.nlm.nih.gov/pubmed/36110537
http://dx.doi.org/10.3389/fphar.2022.948362
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author Guoyun, Xuan
Dawei, Ding
Ning, Liu
Yinan, Hu
Fangfang, Yang
Siyuan, Tian
Hao, Sun
Jiaqi, Yang
Ang, Xu
Guanya, Guo
Xi, Chen
Yulong, Shang
Ying, Han
author_facet Guoyun, Xuan
Dawei, Ding
Ning, Liu
Yinan, Hu
Fangfang, Yang
Siyuan, Tian
Hao, Sun
Jiaqi, Yang
Ang, Xu
Guanya, Guo
Xi, Chen
Yulong, Shang
Ying, Han
author_sort Guoyun, Xuan
collection PubMed
description Background: Ursodeoxycholic acid (UDCA) is currently used for the treatment of primary biliary cholangitis (PBC), but some people do not respond well to UDCA. It reported that the combination of fenofibrate and UDCA can improve the clinical indices in these patients. However, more high-quality evidence is needed to improve guideline recommendations. Methods: Through an updated meta-analysis, studies included were valued by the Cochrane Evaluation Manual and Robins-I. Biochemical and clinical indicator changes in UDCA-refractory PBC patients receiving combination therapy were analyzed by Revman 5.42. Then, we explored the influence of fenofibrate dose and the effectiveness and safety of long-term application by retrospective cohort study. Results: Our meta-analysis included nine publications with a total of 389 patients, including 216 treated with UDCA alone and 173 who received combination therapy. The meta-analysis showed that combination therapy was more effective than UDCA monotherapy in decreasing biochemical parameters, such as ALP, GGT, IgM, and TG. However, the occurrence of pruritus and adverse events was slightly higher with combination therapy than with UDCA monotherapy. A total of 156 patients were included in our cohort study: 68 patients underwent UDCA monotherapy, and 88 patients underwent combination therapy. Among UDCA-refractory patients, fenofibrate add-on therapy significantly improved the ALP normalization rate. Conclusion: The combination of fenofibrate and UDCA can decrease biochemical parameters, of UDCA-refractory PBC patient. Furthermore, the efficacy and safety of long-term combination therapy were also confirmed in our cohort study.
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spelling pubmed-94686672022-09-14 Efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: A retrospective study and updated meta-analysis Guoyun, Xuan Dawei, Ding Ning, Liu Yinan, Hu Fangfang, Yang Siyuan, Tian Hao, Sun Jiaqi, Yang Ang, Xu Guanya, Guo Xi, Chen Yulong, Shang Ying, Han Front Pharmacol Pharmacology Background: Ursodeoxycholic acid (UDCA) is currently used for the treatment of primary biliary cholangitis (PBC), but some people do not respond well to UDCA. It reported that the combination of fenofibrate and UDCA can improve the clinical indices in these patients. However, more high-quality evidence is needed to improve guideline recommendations. Methods: Through an updated meta-analysis, studies included were valued by the Cochrane Evaluation Manual and Robins-I. Biochemical and clinical indicator changes in UDCA-refractory PBC patients receiving combination therapy were analyzed by Revman 5.42. Then, we explored the influence of fenofibrate dose and the effectiveness and safety of long-term application by retrospective cohort study. Results: Our meta-analysis included nine publications with a total of 389 patients, including 216 treated with UDCA alone and 173 who received combination therapy. The meta-analysis showed that combination therapy was more effective than UDCA monotherapy in decreasing biochemical parameters, such as ALP, GGT, IgM, and TG. However, the occurrence of pruritus and adverse events was slightly higher with combination therapy than with UDCA monotherapy. A total of 156 patients were included in our cohort study: 68 patients underwent UDCA monotherapy, and 88 patients underwent combination therapy. Among UDCA-refractory patients, fenofibrate add-on therapy significantly improved the ALP normalization rate. Conclusion: The combination of fenofibrate and UDCA can decrease biochemical parameters, of UDCA-refractory PBC patient. Furthermore, the efficacy and safety of long-term combination therapy were also confirmed in our cohort study. Frontiers Media S.A. 2022-08-30 /pmc/articles/PMC9468667/ /pubmed/36110537 http://dx.doi.org/10.3389/fphar.2022.948362 Text en Copyright © 2022 Guoyun, Dawei, Ning, Yinan, Fangfang, Siyuan, Hao, Jiaqi, Ang, Guanya, Xi, Yulong and Ying. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Guoyun, Xuan
Dawei, Ding
Ning, Liu
Yinan, Hu
Fangfang, Yang
Siyuan, Tian
Hao, Sun
Jiaqi, Yang
Ang, Xu
Guanya, Guo
Xi, Chen
Yulong, Shang
Ying, Han
Efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: A retrospective study and updated meta-analysis
title Efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: A retrospective study and updated meta-analysis
title_full Efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: A retrospective study and updated meta-analysis
title_fullStr Efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: A retrospective study and updated meta-analysis
title_full_unstemmed Efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: A retrospective study and updated meta-analysis
title_short Efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: A retrospective study and updated meta-analysis
title_sort efficacy and safety of fenofibrate add-on therapy in patients with primary biliary cholangitis refractory to ursodeoxycholic acid: a retrospective study and updated meta-analysis
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468667/
https://www.ncbi.nlm.nih.gov/pubmed/36110537
http://dx.doi.org/10.3389/fphar.2022.948362
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