Tu1004 Ursodeoxycholic Acid Therapy Improves Survival of Non-Caucasian Patients With Primary Biliary Cirrhosis With Limited Liver Transplantation Availability
2013; Elsevier BV; Volume: 144; Issue: 5 Linguagem: Inglês
10.1016/s0016-5085(13)63827-5
ISSN1528-0012
AutoresYazmín Karel Melchor-Mendoza, Segundo Morán, Aline Mina Hawat, Gustavo Arturo Rodríguez-Leal, Aldo Torre, Misael Uribe,
Tópico(s)Liver physiology and pathology
Resumoserum alkaline phosphatase (ALP) .1.5xULN who received fenofibrate 160mg/day for 6 months.Wilcoxon Signed-Rank Test was used to compare changes in serial liver chemistries from baseline to the end of 6 months of therapy.Liver biochemistries were again measured at 9 weeks after drug discontinuation.Results: Eight patients (7 male, 1 female, median age 41) with established PSC received fenofibrate 160mg/d for 6 months.Four (50%) had associated inflammatory bowel disease, one of whom also had psoriasis.Median serum alkaline phosphatase (ALP) at baseline was 290 IU/dL (range 216-850) and decreased to 165.5 IU/dL (104-273) at month 6, p=0.008.The median drop in ALP was of 47% (range 21-70%).Serum alanine aminotransferase (ALT) also decreased significantly (108 [40-205] vs. 75 , p= 0.04).There were no significant changes in serum bilirubin, alanine aminotransferase, albumin or prothrombin time.Mayo risk score did not change between baseline and 6 months: median -0.41 (-0.71 to 1.4) vs. -0.46(-0.96 to 1.8), p=0.46.To further demonstrate the effect of fenofibrate, liver biochemistries were measured again at 9 weeks after drug discontinuation.Median serum ALP was 165 (104-273) at month 6 on the drug and increased to 340 (264-670) after drug discontinuation, p= 0.02, demonstrating a clear rebound in ALP levels.Serum ALT increased from 75 (34-119) to 123 (45-191), but this was not statistically significant (p=0.11).The only adverse event was worsening of psoriasis in one study participant which did not require drug discontinuation.Conclusion: Use of fenofibrate 160 mg/d in patients with PSC appears safe and efficacious in reducing serum levels of ALP and ALT.Further studies are warranted.
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