Elafibranor, Seladelpar Show Similar Liver Outcomes

A propensity-matched study of adults with primary biliary cholangitis found no significant 1-year differences between the two second-line treatments.

Updated on Nov. 8, 2026 in Healthcare

Bold vector editorial illustration of a white pill beside a clear glass dropper bottle on a cream background, suggesting two comparable treatment options. — Elafibranor and seladelpar produced similar 1-year liver outcomes, hospitalization, and cardiovascular event rates in a propensity-matched study of adults with primary biliary cholangitis. AI Illustration. Upload story photo >

A propensity-matched comparative effectiveness study compared elafibranor and seladelpar in adults with primary biliary cholangitis receiving ursodeoxycholic acid. The study found no statistically significant differences in 1-year liver outcomes, hospitalization, cardiovascular events, or alkaline phosphatase levels between the two drugs.

Why it matters

The study examined whether real-world evidence could distinguish between these second-line treatment options for primary biliary cholangitis. Its results show the two drugs performed similarly across the measured outcomes, which may inform treatment decisions for patients in the United States.

Major adverse liver outcomes occurred in 12.6% of elafibranor users compared with 15.5% of seladelpar users, a hazard ratio of 0.82, across a database of 111 health systems. Mean alkaline phosphatase was 162.7 U/L with elafibranor and 175.1 U/L with seladelpar, and the differences were not statistically significant.

The players

Cleveland Clinic

Cleveland Clinic is a nonprofit academic medical center in Cleveland, Ohio, known for its hospital system and research programs.

The details

The findings were presented at The Liver Meeting 2026 in Denver. The lead researcher, Mohammad Alabbas of Cleveland Clinic, compared the two therapies using real-world patient data, and the analysis found no significant differences in hospitalization or cardiovascular events.

The 1-year follow-up period measured liver outcomes and hospitalization for the compared patients.
The findings were presented at The Liver Meeting in 2026 in Denver.

Health Landscape

The comparison addresses second-line treatment choices for primary biliary cholangitis after ursodeoxycholic acid, a field where clinicians rely on evidence from large patient databases. The study's use of real-world data from 111 health systems reflects a broader push to test treatments outside of controlled trials.

Patients with primary biliary cholangitis who have not responded to ursodeoxycholic acid may find that either elafibranor or seladelpar performs similarly on liver outcomes and hospitalization. Treatment decisions should still be made with a physician, since the study did not identify a clear winner between the two drugs.

The takeaway

Real-world data from 111 health systems found no significant differences between elafibranor and seladelpar on the measured liver and hospitalization outcomes. Larger studies with longer follow-up are needed before either drug can be ranked above the other.