Mudaliar et al. first showed that administration of OCA to patients with NAFLD and T2DM improved insulin resistance and decreased liver fibrosis markers.68 More recently, the FLINT (FXR Ligand Obeticholic Acid in NASH Treatment; clinicaltrials.gov identifier NCT01265498,) trial,69 which included NASH patients treated with OCA [6α‐ethyl‐CDCA], a potent FXR agonist (25 mg/day for 72 weeks), provided information on the metabolic effects of FXR agonism on glucose and lipid metabolism in humans. The gene discussed is NR1H4; the disease is metabolic dysfunction-associated steatotic liver disease.