Nevertheless, FXR agonists and FGF19 analogs that target and dampen the classical pathway for bile acid synthesis have been quite uniformly reported to reduce liver fat content, NAFLD severity assessed by the NAFLD activity score and/or fibrosis in patients with NAFLD, even if often at the expense of negative side effects such as pruritus and higher atherosclerotic risk [20,35,45,180,181]. Here, NR1H4 is linked to metabolic dysfunction-associated steatotic liver disease.