Recently, it was reported that ‘OCA’ failed to achieve a first therapy against NASH (AuthorAnonymous, 2020), as it was reported that the complete FXR activation inhibits metabolic cholesterol breakdown and limits bile acid production, resulting in increased cholesterol levels in ‘OCA’ clinical studies (Neuschwander-Tetri et al., 2015). The gene discussed is NR1H4; the disease is metabolic dysfunction-associated steatohepatitis.