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. 2020 Jan;16(1):31-38.

Statins, Fibrates, and Other Peroxisome Proliferator-Activated Receptor Agonists for the Treatment of Cholestatic Liver Diseases

Alanna M K Dubrovsky  1 , Christopher L Bowlus  1
Affiliations

Statins, Fibrates, and Other Peroxisome Proliferator-Activated Receptor Agonists for the Treatment of Cholestatic Liver Diseases

Alanna M K Dubrovsky et al. Gastroenterol Hepatol (N Y). 2020 Jan.

Abstract

Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are autoimmune cholestatic liver diseases that commonly result in the need for liver transplantation. The lack of an effective therapy for PSC remains a largely unmet need in hepatology, and although the majority of patients with PBC will have an adequate response to ursodeoxycholic acid and/or obeticholic acid, there is a need for treatment among patients who do not respond completely to these therapies. Investigations of statins, fibrates, and other peroxisome proliferator-activated receptor (PPAR) agonists suggest clinical benefit with some of these agents. Statins have recently been suggested to improve outcomes in patients with PSC but have not demonstrated benefit in patients with PBC, whereas fibrates and newer PPAR agonists appear to improve biochemical markers linked to better clinical outcomes in patients with PBC. Further research is needed to fully understand the clinical efficacy of these agents in the treatment of PBC and PSC.

Keywords: Primary sclerosing cholangitis; fibrates; peroxisome proliferator-activated receptor agonists; primary biliary cholangitis; statins.

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Conflict of interest statement

Dr Bowlus has received grant support from Gilead, Intercept Pharmaceuticals, CymaBay Therapeutics, Takeda, NGM Biosciences, GlaxoSmithKline, Bristol-Myers Squibb, TARGET PharmaSolutions, Genkyotex, Allergan, TaiwanJ Pharmaceuticals, Eli Lilly, Novartis, and BiomX, and has consulted for Intercept Pharmaceuticals, GlaxoSmithKline, Gilead, CymaBay Therapeutics, Pliant Therapeutics, and BiomX. Ms Dubrovsky has no relevant conflicts of interest to disclose.

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