Editing Primary biliary cholangitis (section)

===== Fibrates =====
Fibric acid derivatives, or [[fibrates]], are agonists of the peroxisome proliferator activator receptor (PPAR), a nuclear receptor involved in several metabolic pathways. While fibrates are approved for the treatment of hypertriglyceridemia, they exert anticholestatic effects and have been studied for the treatment of PBC<ref name="AASLD_2018" /> and are used [[Off-label use|off-label]] as a second-line option for patients who do not respond sufficiently to UDCA.<ref name=":2" /> Among the fibrates, [[bezafibrate]] and [[fenofibrate]], PPAR-alpha selective agonists, have been extensively studied as therapeutic agents because of their potential ability to decrease bile acid synthesis and bile acid-related hepatic inflammation. A randomized, controlled trial in 2018 showed its efficacy in patients with inadequate response to UDCA. While fibrates can be considered as off-label treatment for PBC that does not respond to UDCA, they should not be used in decompensated cirrhosis.<ref name="AASLD_2018" />