NR1H4 and metabolic dysfunction-associated steatohepatitis: OCA (or 6-ethylchenodeoxycholic acid) is a bile acid derivative, which is a potent activator of the farnesoid X nuclear receptor, and can reduce liver fat and fibrosis in animal models of NAFLD.48,49 The FLINT trial50 assessed the efficacy of OCA in patients with biopsy-proven NASH.