NR1H4 and metabolic dysfunction-associated steatohepatitis: In addition, obeticholic acid, which has completed Phase III trials as a farnesoid X receptor (FXR) agonist that improves insulin sensitivity and reduces hepatic steatosis, inflammation, and fibrosis, showed promising results in NASH; however, pruritus was present in 23% of treated patients, and low-density lipoprotein cholesterol (LDL-C) was rapidly elevated in some patients.