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A decrease or normalization of alkaline phosphatase (ALP) and bilirubin levels in patients treated for primary biliary cholangitis (PBC) predicts a better survival. Obeticholic acid (OCA) is the approved second-line therapy if ursodeoxycholic acid (UCDA) fails, but its use may worsen pruritus. Adding bezafibrate to UCDA improved biochemical markers of cholestatic liver injury and decreased pruritus severity. Because normalization of ALP and bilirubin was only achieved in a minority of patients in these studies, we explored whether bezafib
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