Effect of ursodeoxycholic acid on bile supersaturated with cholesterol in patients pretreated with clofibrate

To clarify whether it is possible to compensate the lithogenic effect of clofibrate on bile without diminishing effect of clofibrate on bile without diminishing its therapeutic value, studies have been performed in 15 patients with hyperlipoproteinaemia. They received clofibrate (1.5 g/day) for three weeks and then a combination of clofibrate (1.5 g/day) + ursodeoxycholic acid (0.75 g/day) for also three weeks. The serum concentrations of cholesterol, triglycerides and total bile acids as well as the biliary lipid composition (bile acids, phospholipids and cholesterol were assessed before the study, after the clofibrate therapy and after the combined treatment. Both therapeutic regimen lowered the serum cholesterol and triglyceride concentrations. The enhanced cholesterol saturation of bile during clofibrate treatment (lithogenic index of bile: 1.39; 0.73-1.40; median and range) was completely abolished by ursodeoxycholic acid (0.90; 0.62-1.27). It is suggested that this combination may be a useful way for the treatment of patients with hyperlipoproteinaemia.