Accordingly, the first-in-class FXR agonist 6α-ethyl-CDCA (2, 6-ECDCA, INT-747, obeticholic acid, OCA) has gained approval for primary sclerosing cholangitis and is in late-stage clinical trials for NAFLD and NASH underlining the value of FXR as drug target10,11. This evidence concerns the gene NR1H4 and metabolic dysfunction-associated steatohepatitis.