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Erschienen in: Journal of Gastroenterology 7/2010

01.07.2010 | Original Article—Liver, Pancreas, and Biliary Tract

Bezafibrate for the treatment of primary sclerosing cholangitis

verfasst von: Suguru Mizuno, Kenji Hirano, Minoru Tada, Keisuke Yamamoto, Yoko Yashima, Hiroshi Yagioka, Kazumichi Kawakubo, Yukiko Ito, Hirofumi Kogure, Takashi Sasaki, Toshihiko Arizumi, Osamu Togawa, Saburo Matsubara, Yousuke Nakai, Naoki Sasahira, Takeshi Tsujino, Hiroyuki Isayama, Takao Kawabe, Masao Omata, Kazuhiko Koike

Erschienen in: Journal of Gastroenterology | Ausgabe 7/2010

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Abstract

Background

It is known that bezafibrate decreases serum alkaline phosphatase (ALP) in patients with hyperlipidemia, and the efficacy of this drug for the treatment of primary biliary cirrhosis has been confirmed. However, there has been little evidence of its efficacy for the treatment of primary sclerosing cholangitis (PSC).

Methods

Bezafibrate (400 mg/day) was orally administered to 7 consecutive patients with PSC, and we analyzed their clinical features and the drug efficacy in terms of the effect on hepatobiliary enzymes, including ALP, gamma-glutamyl transpeptidase (γ-GTP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) after 6 months. The latest hepatobiliary enzyme levels were also evaluated.

Results

In 3 patients (effective group), the levels of all hepatobiliary enzymes had decreased after 6 months. Mean ALP had decreased to approximately 40% of the baseline in this group. The efficacy of bezafibrate was observed for a long period (range, 8–27 months) in these 3 patients. There seemed to be no definite association between the efficacy of bezafibrate and the clinical features in the short term.

Conclusions

This study showed that bezafibrate could lower the levels of hepatobiliary enzymes in about half of a cohort of patients with PSC.
Literatur
2.
Zurück zum Zitat Porayko MK, Wiesner RH, LaRusso NF, Ludwig J, MacCarty RL, Steiner BL, et al. Patients with asymptomatic primary sclerosing cholangitis frequently have progressive disease. Gastroenterology. 1990;98:1594–602.PubMed Porayko MK, Wiesner RH, LaRusso NF, Ludwig J, MacCarty RL, Steiner BL, et al. Patients with asymptomatic primary sclerosing cholangitis frequently have progressive disease. Gastroenterology. 1990;98:1594–602.PubMed
3.
Zurück zum Zitat LaRusso NF, Shneider BL, Black D, Gores GJ, James SP, Doo E, et al. Primary sclerosing cholangitis: summary of a workshop. Hepatology. 2006;44:746–64.CrossRefPubMed LaRusso NF, Shneider BL, Black D, Gores GJ, James SP, Doo E, et al. Primary sclerosing cholangitis: summary of a workshop. Hepatology. 2006;44:746–64.CrossRefPubMed
4.
Zurück zum Zitat Olsson R, Boberg KM, de Muckadell OS, Lindgren S, Hultcrantz R, Folvik G, et al. High-dose ursodeoxycholic acid in primary sclerosing cholangitis: a 5-year multicenter, randomized, controlled study. Gastroenterology. 2005;129:1464–72.CrossRefPubMed Olsson R, Boberg KM, de Muckadell OS, Lindgren S, Hultcrantz R, Folvik G, et al. High-dose ursodeoxycholic acid in primary sclerosing cholangitis: a 5-year multicenter, randomized, controlled study. Gastroenterology. 2005;129:1464–72.CrossRefPubMed
5.
Zurück zum Zitat Zumoff B. Effect of clofibrate on plasma levels of alkaline phosphatase. N Engl J Med. 1977;297:669.PubMed Zumoff B. Effect of clofibrate on plasma levels of alkaline phosphatase. N Engl J Med. 1977;297:669.PubMed
6.
Zurück zum Zitat Day AP, Feher MD, Chopra R, Mayne PD. The effect of bezafibrate treatment on serum alkaline phosphatase isoenzyme activities. Metabolism. 1993;42:839–42.CrossRefPubMed Day AP, Feher MD, Chopra R, Mayne PD. The effect of bezafibrate treatment on serum alkaline phosphatase isoenzyme activities. Metabolism. 1993;42:839–42.CrossRefPubMed
7.
Zurück zum Zitat Iwasaki S, Tsuda K, Ueta H, et al. Bezafibrate may have a beneficial effect in precirrhotic primary biliary cirrhosis. Hepatol Res. 1999;16:12–8.CrossRef Iwasaki S, Tsuda K, Ueta H, et al. Bezafibrate may have a beneficial effect in precirrhotic primary biliary cirrhosis. Hepatol Res. 1999;16:12–8.CrossRef
8.
Zurück zum Zitat Kita R, Kita-Sasai Y, Hanaoka I, Kimura T, Kokuryu H, Takamatsu S, et al. Beneficial effect of bezafibrate on primary sclerosing cholangitis (three case reports). Am J Gastroenterol. 2002;97:1849–51.CrossRefPubMed Kita R, Kita-Sasai Y, Hanaoka I, Kimura T, Kokuryu H, Takamatsu S, et al. Beneficial effect of bezafibrate on primary sclerosing cholangitis (three case reports). Am J Gastroenterol. 2002;97:1849–51.CrossRefPubMed
9.
Zurück zum Zitat Kurihara T, Maeda A, Shigemoto M, Yamashita K, Kamatani N. Efficacy of bezafibrate in a patient with primary sclerosing cholangitis. J Gastroenterol. 2003;38:300–1.CrossRefPubMed Kurihara T, Maeda A, Shigemoto M, Yamashita K, Kamatani N. Efficacy of bezafibrate in a patient with primary sclerosing cholangitis. J Gastroenterol. 2003;38:300–1.CrossRefPubMed
10.
Zurück zum Zitat Kita R, Takamatsu S, Kimura T, Kokuryu H, Osaki Y, Tomono N. Bezafibrate may attenuate biliary damage associated with chronic liver diseases accompanied by high serum biliary enzyme levels. J Gastroenterol. 2006;41:686–92.CrossRefPubMed Kita R, Takamatsu S, Kimura T, Kokuryu H, Osaki Y, Tomono N. Bezafibrate may attenuate biliary damage associated with chronic liver diseases accompanied by high serum biliary enzyme levels. J Gastroenterol. 2006;41:686–92.CrossRefPubMed
11.
Zurück zum Zitat Lindor KD, LaRusso NF. Primary sclerosing cholangitis. In: Schiff ER, Sorrell MF, editors. Schiff’s diseases of the liver. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 673–84. Lindor KD, LaRusso NF. Primary sclerosing cholangitis. In: Schiff ER, Sorrell MF, editors. Schiff’s diseases of the liver. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 673–84.
12.
Zurück zum Zitat Chari ST, Smyrk TC, Levy MJ, Topazian MD, Takahashi N, Zhang L, et al. Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience. Clin Gastroenterol Hepatol. 2006;4:1010–6. quiz 934.CrossRefPubMed Chari ST, Smyrk TC, Levy MJ, Topazian MD, Takahashi N, Zhang L, et al. Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience. Clin Gastroenterol Hepatol. 2006;4:1010–6. quiz 934.CrossRefPubMed
13.
Zurück zum Zitat Okazaki K, Kawa S, Kamisawa T, Naruse S, Tanaka S, Nishimori I, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006;41:626–31.CrossRefPubMed Okazaki K, Kawa S, Kamisawa T, Naruse S, Tanaka S, Nishimori I, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol. 2006;41:626–31.CrossRefPubMed
14.
Zurück zum Zitat Stiehl A, Walker S, Stiehl L, Rudolph G, Hofmann WJ, Theilmann L. Effect of ursodeoxycholic acid on liver and bile duct disease in primary sclerosing cholangitis. A 3-year pilot study with a placebo-controlled study period. J Hepatol. 1994;20:57–64.CrossRefPubMed Stiehl A, Walker S, Stiehl L, Rudolph G, Hofmann WJ, Theilmann L. Effect of ursodeoxycholic acid on liver and bile duct disease in primary sclerosing cholangitis. A 3-year pilot study with a placebo-controlled study period. J Hepatol. 1994;20:57–64.CrossRefPubMed
15.
Zurück zum Zitat Lindor KD. Ursodiol for primary sclerosing cholangitis. Mayo Primary Sclerosing Cholangitis-Ursodeoxycholic Acid Study Group. N Engl J Med. 1997;336:691–5.CrossRefPubMed Lindor KD. Ursodiol for primary sclerosing cholangitis. Mayo Primary Sclerosing Cholangitis-Ursodeoxycholic Acid Study Group. N Engl J Med. 1997;336:691–5.CrossRefPubMed
16.
Zurück zum Zitat van Hoogstraten HJ, Wolfhagen FH, van de Meeberg PC, Kuiper H, Nix GA, Becx MC, et al. Ursodeoxycholic acid therapy for primary sclerosing cholangitis: results of a 2-year randomized controlled trial to evaluate single versus multiple daily doses. J Hepatol. 1998;29:417–23.CrossRefPubMed van Hoogstraten HJ, Wolfhagen FH, van de Meeberg PC, Kuiper H, Nix GA, Becx MC, et al. Ursodeoxycholic acid therapy for primary sclerosing cholangitis: results of a 2-year randomized controlled trial to evaluate single versus multiple daily doses. J Hepatol. 1998;29:417–23.CrossRefPubMed
17.
Zurück zum Zitat Iwasaki S, Ohira H, Nishiguchi S, Zeniya M, Kaneko S, Onji M, et al. The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis: a prospective, multicenter study. Hepatol Res. 2008;38:557–64.CrossRefPubMed Iwasaki S, Ohira H, Nishiguchi S, Zeniya M, Kaneko S, Onji M, et al. The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis: a prospective, multicenter study. Hepatol Res. 2008;38:557–64.CrossRefPubMed
18.
Zurück zum Zitat Davies YK, Cox KM, Abdullah BA, Safta A, Terry AB, Cox KL. Long-term treatment of primary sclerosing cholangitis in children with oral vancomycin: an immunomodulating antibiotic. J Pediatr Gastroenterol Nutr. 2008;47:61–7.CrossRefPubMed Davies YK, Cox KM, Abdullah BA, Safta A, Terry AB, Cox KL. Long-term treatment of primary sclerosing cholangitis in children with oral vancomycin: an immunomodulating antibiotic. J Pediatr Gastroenterol Nutr. 2008;47:61–7.CrossRefPubMed
19.
Zurück zum Zitat Takikawa H. Recent status of primary sclerosing cholangitis in Japan. J Hepatobiliary Pancreat Surg. 1999;6:352–5.CrossRefPubMed Takikawa H. Recent status of primary sclerosing cholangitis in Japan. J Hepatobiliary Pancreat Surg. 1999;6:352–5.CrossRefPubMed
20.
Zurück zum Zitat Hirano K, Tada M, Isayama H, Yashima Y, Yagioka H, Sasaki T, et al. Clinical features of primary sclerosing cholangitis with onset age above 50 years. J Gastroenterol. 2008;43:729–33.CrossRefPubMed Hirano K, Tada M, Isayama H, Yashima Y, Yagioka H, Sasaki T, et al. Clinical features of primary sclerosing cholangitis with onset age above 50 years. J Gastroenterol. 2008;43:729–33.CrossRefPubMed
Metadaten
Titel
Bezafibrate for the treatment of primary sclerosing cholangitis
verfasst von
Suguru Mizuno
Kenji Hirano
Minoru Tada
Keisuke Yamamoto
Yoko Yashima
Hiroshi Yagioka
Kazumichi Kawakubo
Yukiko Ito
Hirofumi Kogure
Takashi Sasaki
Toshihiko Arizumi
Osamu Togawa
Saburo Matsubara
Yousuke Nakai
Naoki Sasahira
Takeshi Tsujino
Hiroyuki Isayama
Takao Kawabe
Masao Omata
Kazuhiko Koike
Publikationsdatum
01.07.2010
Verlag
Springer Japan
Erschienen in
Journal of Gastroenterology / Ausgabe 7/2010
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-010-0204-x

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