NR1H4 and primary biliary cholangitis: In recent years OCA, a FXR agonist, first approved in 2016 as a second-line therapy for PBC, has shown efficacy in reducing ALP, but side effects associated with this agent seem to preclude its further use [190], and in June 2024, the EMA recommended revoking conditional marketing authorization for OCA in the EU (https://www.ema.europa.eu/en/news/ema-recommends-revoking-conditional-marketing-authorisation-ocaliva accessed on 29 August 2024).