Iqirvo: A New Treatment Option for Primary Biliary Cholangitis

Written by Jennifer Phillips, PharmD
Medically Reviewed by Simi Burn, PharmD on February 07, 2025
5 min read

Iqirvo (elafibranor) is a medicine that can help treat primary biliary cholangitis (PBC) by reducing the amount of bile in your body. It does this by signaling the body to stop making bile acid. 

People with PBC usually have a buildup of bile in their body. You may have no symptoms, or you may have fatigue or itching. Over time, you may have more serious symptoms due to the buildup of bile in your body. Too much bile in the body can lead to inflammation and damage to the liver.

Iqirvo is usually taken with another medicine for PBC called ursodeoxycholic acid. 

Iqirvo was studied in 161 people with PBC. The people in the study were treated for at least a year with either 80 mg of Iqirvo daily or a placebo pill. Placebo pills do not contain any active medicine. After a year, people could stay in the study for up to another year. 

In this study, most people were also taking another medicine for PBC – ursodeoxycholic acid (also called ursodiol or urso) – unless they were allergic or had side effects from that medication.

The investigators of this study looked to see if there were any improvements in liver laboratory values, such as the alkaline phosphatase level and bilirubin level, to see if the medicine worked. They also checked improvements in itching by looking at scores on a rating scale called the Worst Itch Numeric Rating Scale (WI-NRS) at weeks 24 and 52. 

The average age for people in this study was about 57 years, and most of the people (96%) were female. Most of the people in this study were White (91%). 

About 95% of people in this study were also taking ursodeoxycholic acid for their PBC.

About 51% of people who received Iqirvo had improvements in their liver laboratory values. Only 4% of people who received the placebo pill had improvements in these laboratory values.

People treated with Iqirvo did show some improvements in itching based on the WI-NRS itching scale. But this was similar to the improvements seen in people who were taking the placebo pill. 

Your results may differ from what was seen in clinical studies. 

In the clinical study, people began to see improvements in their liver laboratory values by week four, which continued through week 52.

You should not take Iqirvo if any of the following apply.

  • You have advanced liver disease, including an advanced form of cirrhosis known as decompensated cirrhosis.
  • You have a blockage of the bile ducts in your liver, also known as biliary obstruction.
  • You are pregnant.
  • You are breastfeeding.

Although not common, some people who were treated with Iqirvo in clinical studies had bone fractures. Tell your health care provider if you have had a fracture in the past or are at risk of getting fractures. Below are some things you can do to improve your bone health.

  • Make sure you are getting enough calcium from supplements or calcium-rich foods such as yogurt, tofu, or salmon.
  • Make sure you are getting enough vitamin D from supplements or vitaminD-rich foods such as fatty fish, eggs, or fortified eggs or cereal.
  • Exercise regularly. This can help build muscle and reduce your risk of falling.
  • Quit smoking if you are a smoker.
  • Reduce your intake of added sugars.
  • Limit alcohol intake.

Common side effects with Iqirvo include weight changes, stomach pain, nausea, vomiting, constipation, heartburn, dry mouth, muscle pain or injury, rash, and joint stiffness. Below are some tips for managing some of these side effects.

  • If you have nausea or vomiting, try to drink clear liquids or ginger ale. Bland foods like crackers or toast may help as well.
  • To help with constipation, make sure you are getting enough fluids as well as fruits, vegetables, and fiber-rich foods or supplements. Consider using probiotics like yogurt or kefir. Avoid processed foods and refined carbs.
  • Heartburn, or gastroesophageal reflux disease, can be managed with antacids and certain over-the-counter medicines like famotidine (Pepcid), lansoprazole (Prevacid), omeprazole (Prilosec) or ranitidine (Zantac). If you have heartburn, avoid foods that can trigger it such as chocolate, peppermint, fatty foods, caffeine, and alcohol. Try eating smaller serving sizes, and chew slowly and thoroughly. 
  • If you have dry mouth, try sucking on sugar-free candy or chewing sugar-free gum. Ice chips or sugar-free popsicles may help as well. Ensure you are getting enough water. Try to breathe through your nose instead of your mouth. Consider using a room vaporizer. 

Several medicines can interact with Iqirvo. This can affect how well it works or increase your risk of side effects. Some medicines that interact with Iqirvo are summarized below.

  • Birth control pills, patches, or implants may not work as well when you are taking Iqirvo. This may cause breakthrough bleeding or failure of those medicines to prevent pregnancy. You should switch to an effective non-hormone-based contraceptive or add a barrier method such as condoms when taking Iqirvo and for at least three weeks after your last dose. 
  • Medicines used for high cholesterol called statins may increase your risk of muscle pain or injury while you’re taking Iqirvo. Tell your health care provider right away if you have any muscle pain or injury while taking Iqirvo. 
  • Medicines known as bile acid sequestrants may attach to Iqirvo and prevent it from being absorbed into your bloodstream. Medicine that is not absorbed cannot get to the site of action to work. These medicines are sometimes used to lower cholesterol and include cholestyramine, colesevelam (Welchol), and colestipol (Colestid). If you are taking one of these medicines, you should not take it at the same time that you take your Iqirvo. Take Iqirvo at least four hours before or four hours after your bile acid sequestrant. 
  • Rifampin, which is a medicine commonly used to treat an infection called tuberculosis, may decrease the amount of Iqirvo that is present in the body. Your health care provider may obtain laboratory values to make sure that Iqirvo is working properly if you are on both of these medicines. 

It is important to let your health care provider and pharmacist know about any other medicines that you are taking.

This may not be a complete list of medicines that interact with Iqirvo. Always check with your health care provider. 

There may be cost assistance to help you afford Iqirvo. You may have options even if you do not have health insurance. Ipsen Cares is a service that can help with access to medications and coordination of care. Your health care provider can help you get started, or you can call 866-435-5677.