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FIGURE 3 The pharmacokinetic properties of urinary-excreted phytochemicals play a vital role in their effectiveness in managing IC

Evanno, E

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Phytomedicines of Europe: Chemistry and Bological Activity

Retrieved from: Jensen, E

Bezafibrate is a strong and predominant PPAR ligand with activity for other isoforms and therefore is sometimes also referred to as pan PPAR ligand.140 141 PPAR alpha Despite their key role in lipid metabolism and management of dyslipidaemia,140 PPAR ligands (fibrates) did not show convincing efficacy in NASH in smaller pilot studies.144 However, several studies have demonstrated beneficial effects of fibrates (bezafibrate and fenofibrate) in cholestasis which seem to be mediated by repression of BA synthesis, stimulation of phospholipid excretion (counteracting intrinsic BA toxicity on bile ducts) and anti-inflammatory effects (via suppression of NFB signalling).143 Bezafibrate 400 mg/day over 24-month resulted in complete biochemical response in 31% of patients with PBC with an incomplete response to UDCA70 (table 1)