Elafibranor for previously treated primary biliary cholangitis

Elafibranor

• is an agonist of the peroxisome proliferator-activated receptors (PPAR) alpha (α), delta (δ), and gamma (γ), intracellular receptors with major effects on bile acid synthesis and transport as well as lipid metabolism and glucose homeostasis (1):
  • studies of other PPAR agonists such as pioglitazone and fenofibrate have suggested at least partial improvement in disease activity with their use in several liver diseases
    • the PPARα agonist bezafibrate has been shown to improve liver tests and histology in patients with primary biliary cholangitis
    • elafibranor has been shown to improve serum enzymes in several diseases including nonalcoholic steatohepatitis (NASH) and primary biliary cholangitis (1)

NICE states (2):

• Elafibranor is recommended, within its marketing authorisation, as an option for treating primary biliary cholangitis in adults, when used:
  • with ursodeoxycholic acid (UDCA), if the primary biliary cholangitis has not responded well enough to UDCA, or
  • alone, if UDCA cannot be tolerated

Reference:

1. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Elafibranor. [Updated 2024 Jul 24]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK605979/
2. NICE (November 2024). Elafibranor for previously treated primary biliary cholangitis