Fenofibrate in Combination With Ursodeoxycholic Acid (UDCA) in Primary Biliary Cirrhosis

Inclusion Criteria: 1. Age ≥ 21 and ≤ 75 years old 2. Established diagnosis of PBC and positive AMA 3. Previous treatment with UDCA 13-15 mg/kg/day for at least 1 year 4. Incomplete response to UDCA defined as serum ALP ≥ 2 times the upper limit of normal on two separate measurements despite at least 1 year of therapy with UDCA 5. Female patients of childbearing age need a negative pregnancy test performed within 7 days of enrollment, and need to be on adequate contraception throughout the study period 6. Signed informed consent after careful review of information and study details Exclusion Criteria: 1. Hypersensitivity to fenofibrate 2. Administration of the following drugs at any time during the 3 months prior to screening for the study: methotrexate, colchicines, azathioprine, systemic steroids. 3. Prisoners and institutionalized subjects, pregnant or nursing women 4. Anticipated need for liver transplantation within one year (estimated 1-year survival \<80% as predicted by the Mayo risk score). 5. Recipients of liver transplantation 6. Recurrent variceal hemorrhage, uncontrolled encephalopathy or refractory ascites 7. Co-existing liver diseases such as acute or chronic viral hepatitis, alcoholic liver disease, choledocholithiasis, autoimmune hepatitis, biopsy-proven non-alcoholic fatty liver disease, Wilson's disease and hemochromatosis 8. Acute or chronic renal failure, defined as GFR \< 60 ml/min 9. Known history of cholecystitis with intact gallbladder 10. History of, or known high risk for, venous thromboembolism 11. Current use of warfarin or statins