Prednisone and Ursodeoxycholic Acid for Primary Biliary Cholangitis with Interface Hepatitis
UDCA (Ursodeoxycholic acid)
Bile Duct Diseases+8
+ Biliary Tract Diseases
+ Cholestasis
Treatment Study
Summary
Study start date: October 30, 2024
Actual date on which the first participant was enrolled.This study focuses on patients with primary biliary cholangitis (PBC), a liver disease where the immune system mistakenly attacks bile ducts, leading to liver damage. Some patients with PBC experience a specific type of liver inflammation known as moderate to severe interface hepatitis, which does not respond well to the standard treatment with Ursodeoxycholic Acid (UDCA). The study aims to investigate if adding the steroid prednisone to UDCA can improve outcomes for these patients. This research is important as it seeks to offer new treatment options for a group of patients who currently have limited therapeutic choices. Participants in the study will receive a combination of UDCA and prednisone to assess whether this treatment is more effective than UDCA alone. The treatment involves taking these medications orally. Researchers will monitor the patients' liver function and overall health to evaluate the effectiveness and safety of the combined treatment. By measuring these factors, the study will determine if the combination therapy can provide better management of the disease with an acceptable safety profile.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.244 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.From 18 to 75 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
Inclusion Criteria: 1. Voluntarily joining the group, able to understand and sign an informed consent form; 2. 18 years old ≤ age ≤ 75 years old; 3. The diagnosis of primary biliary cholangitis follows the AASLD international diagnostic and treatment guidelines (meeting two of the following three criteria: AMA or gp210, sp100 positive; Elevated serum ALP levels; Pathological manifestations include non suppurative cholangitis and destruction of the interlobular bile duct; 4. Liver histology suggests moderate to severe interfacial hepatitis (moderate,\<50% portal or fibrous septa destruction, severe,\>50% portal or fibrous septa destruction) with serum ALT\<5 \* ULN, serum IgG\<2 \* ULN, and negative serum anti smooth muscle antibodies; 5. Not receiving UDCA, hormone or other immunosuppressive therapy before enrollment; 6. ALP\>1.67 \* ULN. Exclusion Criteria: * History or presence of other concomitant liver diseases. * ALT or AST \> 5×ULN, TBIL \> 3×ULN. * If female: known pregnancy, or has a positive urine pregnancy test (confirmed by a positive serum pregnancy test), or lactating. * Allergic to fenofibrate or ursodeoxycholic acid. * Taking hepatotoxic drugs (e.g., dapsone, erythromycin, fluconazole, ketoconazole, rifampicin) for more than 2 weeks within 6 months, and long-term hormonal users. * Recurrent variceal bleeding, poorly controlled hepatic encephalopathy or refractory ascites. * Patients with a history of severe cardiac, cerebrovascular, renal, respiratory disease or functional failure, and psychiatric disorders (including those due to alcohol and drug abuse). * Creatinine \>1.5×ULN and creatinine clearance \<60 ml/min. * Currently using statins (such as pravastatin, fluvastatin, and simvastatin), other fibrates (such as gemfibrozil and bezafibrate), and drugs structurally similar to fenofibrate (like ketoprofen). * Planned to receive an organ transplant or an organ transplant recipient. * Needing Liver transplantation within 1 year according to the Mayo Rick score. * Any other condition(s) that would compromise the safety of the subject or compromise
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.One single intervention group is designated in this study
This study does not include a placebo group
Treatment Groups
Group I
Active ComparatorStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 2 locations
Xijing hospital
Xi'an, China