Patients with primary biliary cirrhosis who show incomplete response to ursodeoxycholic acid (UDCA) are at significantly increased risk, and development of secondline therapies for PBC is an area of active research.
Fibrates have been postulated as alternative second-line therapies, with a plausible mechanism of action (they are PPARa agonists) and some data supporting efficacy.
The data have been, however, largely limited to case series and small and/or short term uncontrolled studies using biochemical end-points. Cheung et al. have addressed one of these limitations, reporting the largest study to date of fenofibrate use in PBC. [...]