The direct effects on hepatic fibrosis are more controversial given that discrepant data have been published.22, 67 Of note, it has been reported that the long‐term use of a synthetic FXR agonist can be associated with body weight gain and glucose intolerance as well as worsening of hepatic steatosis.60 These effects are possibly related to reduction of the BA pool and energy expenditure and are not observed with natural ligands or BA‐derived FXR agonists. This evidence concerns the gene NR1H4 and Hepatic fibrosis.