Efficacy and safety of PPAR agonists in primary biliary cholangitis: a systematic review and meta-analysis of Randomized Controlled Trials.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

BMC Gastroenterology Pub Date : 2025-04-08 DOI:10.1186/s12876-025-03821-2

Behrad Saeedian, Nastaran Babajani, Tannaz Bagheri, Fatemeh Ojaghi Shirmard, Seyed Morteza Pourfaraji

{"title":"Efficacy and safety of PPAR agonists in primary biliary cholangitis: a systematic review and meta-analysis of Randomized Controlled Trials.","authors":"Behrad Saeedian, Nastaran Babajani, Tannaz Bagheri, Fatemeh Ojaghi Shirmard, Seyed Morteza Pourfaraji","doi":"10.1186/s12876-025-03821-2","DOIUrl":null,"url":null,"abstract":"Background and aims: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease. Some patients with PBC do not adequately respond to Ursodeoxycholic acid (UDCA) as a first-line treatment, putting them at an increased risk of disease progression. Peroxisome Proliferator-Activated Receptor (PPAR) agonists are emerging as promising therapeutic options for PBC. We aim to investigate the efficacy and safety of PPAR agonists in treating PBC patients.Methods: PubMed, EMBASE, Cochrane Library, and Clinicaltrials.gov were searched for Randomized Controlled Trials (RCTs) investigating the use of PPAR agonists in combination with UDCA in patients with PBC, compared to UDCA alone. Mean differences (MD) for continuous variables and risk ratios (RR) for dichotomous variables were calculated to compare treatment response endpoints.Results: A total of 17 studies with 1219 PBC cases were included in the current review. Alkaline phosphatase (ALP) levels had a significantly greater decline in PPAR and UDCA arms than in UDCA alone (MD - 131.15, 95% CI - 155.95 to - 106.36). Furthermore, in combination therapy arms, gamma-glutamyl transferase (GGT) (MD - 55.69, 95% CI - 76.26 to - 35.13) and total bilirubin (MD - 0.08, 95% CI - 0.14 to - 0.03) were significantly lower than in the UDCA alone group.Conclusions: The current study demonstrates that combining UDCA and PPAR agonists effectively reduces ALP, GGT, and Bilirubin levels, crucial markers for effective therapy in PBC patients.","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"230"},"PeriodicalIF":2.5000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12876-025-03821-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and aims: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease. Some patients with PBC do not adequately respond to Ursodeoxycholic acid (UDCA) as a first-line treatment, putting them at an increased risk of disease progression. Peroxisome Proliferator-Activated Receptor (PPAR) agonists are emerging as promising therapeutic options for PBC. We aim to investigate the efficacy and safety of PPAR agonists in treating PBC patients.

Methods: PubMed, EMBASE, Cochrane Library, and Clinicaltrials.gov were searched for Randomized Controlled Trials (RCTs) investigating the use of PPAR agonists in combination with UDCA in patients with PBC, compared to UDCA alone. Mean differences (MD) for continuous variables and risk ratios (RR) for dichotomous variables were calculated to compare treatment response endpoints.

Results: A total of 17 studies with 1219 PBC cases were included in the current review. Alkaline phosphatase (ALP) levels had a significantly greater decline in PPAR and UDCA arms than in UDCA alone (MD - 131.15, 95% CI - 155.95 to - 106.36). Furthermore, in combination therapy arms, gamma-glutamyl transferase (GGT) (MD - 55.69, 95% CI - 76.26 to - 35.13) and total bilirubin (MD - 0.08, 95% CI - 0.14 to - 0.03) were significantly lower than in the UDCA alone group.

Conclusions: The current study demonstrates that combining UDCA and PPAR agonists effectively reduces ALP, GGT, and Bilirubin levels, crucial markers for effective therapy in PBC patients.

查看原文本刊更多论文

PPAR激动剂治疗原发性胆管炎的疗效和安全性：随机对照试验的系统回顾和荟萃分析。

背景和目的：原发性胆道胆管炎（PBC）是一种慢性进行性自身免疫性肝病。一些PBC患者对熊去氧胆酸（UDCA）作为一线治疗没有充分的反应，使他们处于疾病进展的风险增加。过氧化物酶体增殖物激活受体（PPAR）激动剂正在成为PBC的有希望的治疗选择。我们的目的是研究PPAR激动剂治疗PBC患者的有效性和安全性。方法：检索PubMed、EMBASE、Cochrane Library和Clinicaltrials.gov，研究PPAR激动剂联合UDCA治疗PBC患者的随机对照试验（RCTs），并与单独使用UDCA进行比较。计算连续变量的平均差异（MD）和二分类变量的风险比（RR）来比较治疗反应终点。结果：本综述共纳入17项研究，1219例PBC病例。碱性磷酸酶（ALP）水平在PPAR和UDCA组的下降幅度明显大于UDCA组（MD - 131.15, 95% CI - 155.95至- 106.36）。此外，在联合治疗组，γ -谷氨酰转移酶（GGT）（MD - 55.69, 95% CI - 76.26至- 35.13）和总胆红素（MD - 0.08, 95% CI - 0.14至- 0.03）显著低于UDCA单独治疗组。结论：目前的研究表明，联合UDCA和PPAR激动剂可有效降低PBC患者的ALP、GGT和胆红素水平，这是有效治疗PBC患者的关键指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMC Gastroenterology 医学-胃肠肝病学

CiteScore

4.20

自引率

0.00%

发文量

465

审稿时长

6 months

期刊介绍： BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.