Obeticholic acid and other FXR agonists represent a promising therapeutic avenue by regulating bile acid synthesis, improving glucose homeostasis, reducing inflammation, and fibrosis [3]. Obeticholic acid, elafibranor, selonsertib, and cenicriviroc are currently undergoing phase III randomized controlled trials to evaluate their potential therapeutic benefits for MASLD [30]. Several phase II and III studies have already assessed the efficacy and safety of these new agents in treating MASLD and MASH, showing promise as potential treatment options [30]. This evidence concerns the gene NR1H4 and metabolic dysfunction-associated steatohepatitis.