The investigational FGF19 analogue aldafermin (NGM-282) (0.3–3 mg/d) failed to meet the primary endpoint of the 24-week phase 2b ALPINE 2/3 trial in NASH patients with stage 2 or 3 liver fibrosis, defined as a ≥1 NASH Clinical Research Network stage improvement in fibrosis with no worsening of NASH. This evidence concerns the gene FGF19 and metabolic dysfunction-associated steatohepatitis.