AIM:Primary biliary cirrhosis(PBC)is a chronic,cholestaticdisease of autoimmune etiology,the histology of whichshows a destruction of the intrahepatic bile duct and portalinflammation.Ursodeoxycholic acid(UDCA)is now used asa first-line drug for asymptomatic PBC(aPBC)because it isreported that UDCA decreases mortality and prolongs thetime of liver transplantation.However,only 20-30% ofpatients respond fully to UDCA.Recently,lipoprotein-lowering agents have been found to be effective for PBC.The aim of this study was to examine the safety and efficacyof fenofibrate,a member of the fibrate class of hypolipidemicand anti-inflammatory agent via peroxysome proliferatory-activated receptor α,in patients with aPBC.METHODS:Fenofibrate was administered for twelve weeksin nine patients with aPBC who failed to respond to UDCA.UDCA was used along with fenofibrate during the study.The data from aPBC patients were analyzed to assess thebiochemical effect of fenofibrate during the study.RESULTS:The serum levels of alkaline phosphatase(ALP)(285±114.8 IU/L)and immunoglobulin M(IgM)(255.8±85.9mg/dl)significantly decreased to 186.9±76.2 IU/L and192.9±67.5 mg/dL respectively,after fenofibrate treatmentin patients with aPBC(P<0.05).Moreover,the titer ofantimitochondrial antibody(AMA)also decreased in 4 of 9patients with aPBC.No adverse reactions were observed inany patients.CONCLUSION:Fenofibrate appears to be significantlyeffective in treating patients with aPBC who respondincompletely to UDCA alone.Although the mechanism offenofibrate on aPBC has not yet been fully clarified,combination therapy using fenofibrate and UDCA might berelated to the anti-immunological effects,such as thesuppression of AMA production as well as its anti-inflammatory effect. AIM: Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology, the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA) is now used as first-line drug for asymptomatic PBC (aPBC) because it isreported that UDCA decreases mortality and prolongs the time of liver transplantation. However, only 20-30% ofpatients respond fully to UDCA.Recently, lipoprotein-lowering agents have been found to be effective for PBC. Aim of this study was to examine the safety and efficacy of fenofibrate, a member of the fibrate class of hypolipidemic and anti-inflammatory agents via peroxysome proliferatory-activated receptor alpha, in patients with a PBMC. METHODS: Fenofibrate was administered for twelve weeks in nine patients with a PBBC ​​who failed to respond to UDCA. UDCA was used along with fenofibrate during the study. Data from aPBC patients were analyzed to assess thebiochemical effect of fenofibrate during the study .RESULTS: The serum levels of alkaline phosphatase (ALP) (285 ± 114.8 IU / L) and immunoglobulin M (IgM) (255.8 ± 85.9 mg / dl) were significantly decreased to 186.9 ± 76.2 IU / L and 192.9 ± 67.5 mg / dL respectively fenofibrate treatment in patients with aPBC (P <0.05) .oreover, the titer of antimitochondrial antibody (AMA) also decreased in 4 of 9 patients with aPBC. No adverse reactions were observed in patients. CONCLUSION: Fenofibrate appears to be significantlyffective in treating patients with aPBC who respondincompletely to UDCA alone. Though the mechanism offenofibrate on aPBC has not yet been fully clarified, combination therapy using fenofibrate and UDCA might berelated to the anti-immunological effects, such as the suppression of of AMA production as well as its anti-inflammatory effect.