Digestive Diseases and Sciences

, Volume 55, Issue 2, pp 476–483 | Cite as

Moexipril for Treatment of Primary Biliary Cirrhosis in Patients with an Incomplete Response to Ursodeoxycholic Acid

  • Phunchai Charatcharoenwitthaya
  • Jayant A. Talwalkar
  • Paul Angulo
  • Andrea A. Gossard
  • Jill C. Keach
  • Janice L. Petz
  • Roberta A. Jorgensen
  • Keith D. Lindor
Original Article


Blockade of angiotensin II synthesis attenuates hepatic fibrosis in different experimental models of chronic liver injury. We evaluated the safety and efficacy of moexipril, an angiotensin-converting enzyme inhibitor, in patients with primary biliary cirrhosis (PBC) who have had a suboptimal response to ursodeoxycholic acid (UDCA). Twenty PBC patients on UDCA (13–15 mg/kg/day) therapy with an elevation of serum alkaline phosphatase at least twice the upper limit of normal were treated with oral moexipril 15 mg/day for one year. No significant changes in serum alkaline phosphatase (379 ± 32 vs. 379 ± 51), bilirubin (0.8 ± 0.1 vs. 0.9 ± 0.1), aspartate aminotransferase (60 ± 8 vs. 63 ± 9), and Mayo risk score (3.55 ± 0.2 vs. 3.62 ± 0.2) was associated with the treatment. Fatigue and health-related quality of life scores during treatment demonstrated a trend toward improvement. Moexipril was not clinically beneficial to PBC patients responding suboptimally to UDCA.


Primary biliary cirrhosis Angiotensin-converting enzyme inhibitor Ursodeoxycholic acid Treatment 



Phunchai Charatcharoenwitthaya was supported by a grant from the Faculty of Medicine, Siriraj Hospital, Mahidol University. Schwarz Pharma, Milwaukee, WI, USA, provided moexipril for this study but had no involvement in trial design/execution, manuscript writing, or review.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Phunchai Charatcharoenwitthaya
    • 1
  • Jayant A. Talwalkar
    • 1
  • Paul Angulo
    • 1
  • Andrea A. Gossard
    • 1
  • Jill C. Keach
    • 1
  • Janice L. Petz
    • 1
  • Roberta A. Jorgensen
    • 1
  • Keith D. Lindor
    • 1
  1. 1.Division of Gastroenterology and HepatologyMayo Clinic and FoundationRochesterUSA

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