Fenofibrate for Compensated Cirrhosis Patients With Primary Biliary Cholangitis

This study is testing fenofibrate — a commonly used cholesterol-lowering drug — as an add-on treatment for patients with Primary Biliary Cholangitis (PBC) who also have compensated liver cirrhosis and have not responded adequately to standard therapy with ursodeoxycholic acid (UDCA). PBC is a chronic autoimmune liver disease that progressively damages the bile ducts, leading to cirrhosis and, in advanced cases, liver failure. Fenofibrate activates a receptor that may reduce inflammation and bile duct injury, potentially slowing disease progression. To participate, you must be between 18 and 75 years old, have a confirmed PBC diagnosis, have compensated cirrhosis (liver scarring that has not yet caused major liver failure), and have had an incomplete response to UDCA (liver enzymes still elevated after at least 6 months of therapy). People with other liver diseases, liver failure indicators, allergies to fenofibrate or UDCA, recent hepatotoxic drug use, variceal bleeding, or severe heart/kidney disease are not eligible. Participants will receive fenofibrate in addition to their ongoing UDCA therapy and be monitored for liver function improvement. This research is important because PBC patients with cirrhosis who don't respond to UDCA face a high risk of liver failure and need transplant. Finding an effective second-line treatment could significantly extend and improve quality of life for this population.