Obeticholic acid (OCA), a semisynthetic bile acid derivate and full agonist of FXR, has been approved for the treatment of primary biliary cirrhosis (PBC) [10] and has also been evaluated in a phase III clinical trial for nonalcoholic steatohepatitis (NASH) treatment [11,12]. The gene discussed is NR1H4; the disease is metabolic dysfunction-associated steatohepatitis.