Lancet 394, 2184–2196 (2019)

A therapy targeting the liver farnesoid X receptor is showing promise for clinical benefit against non-alcoholic steatohepatitis (NASH).

NASH is a common cause of chronic liver disease, and its incidence is rising worldwide; however, the best current therapy is lifestyle intervention. Obeticholic acid is an agonist of the farnesoid X nuclear receptor that serves a role in the regulation of bile acids, and its activation is known to reduce hepatic fibrosis and inflammation, both of which are associated with the pathology of NASH.

A phase III clinical trial of obeticholic acid for NASH is ongoing in 320 centers in 20 countries across the world, including 1,968 patients. In an interim analysis, obeticholic acid significantly improved fibrosis and is expected to be of clinical benefit.