Steroidal and non-steroidal FXR agonists (e.g., obeticholic acid and newer intestine-biased FXR agonists) consistently improve metabolic dysfunction-associated steatohepatitis histology and reduce liver fibrosis in phase 2 and 3 trials, but their effects on body weight, insulin resistance and systemic inflammatory markers are more modest than anticipated from preclinical studies [269,277,278]. Here, INS is linked to Hepatic fibrosis.