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

Alanna M K Dubrovsky; Christopher L Bowlus

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

Gastroenterol Hepatol (N Y). 2020 Jan;16(1):31-38.

Authors

Alanna M K Dubrovsky¹, Christopher L Bowlus¹

Affiliation

¹ Ms Dubrovsky is a medical student and Dr Bowlus is a professor and chief of the Division of Gastroenterology and Hepatology at the University of California Davis School of Medicine in Sacramento, California.

PMID: 33867886
PMCID: PMC8040906

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.