Obeticholic Acid, FXR Agonists, Liver Disease and Plasma Biomarkers

Abstract

How medications whose major biologic effect is to reduce bile acid synthesis favorably affect the course of a variety of cholestatic and metabolic liver diseases is not immediately apparent. Also, the most frequently used plasma biomarkers for evaluating benefit, alkaline phosphatase and conjugated bilirubin [1], provide different information. The former may be misleading with respect to the course of the disease and therefore it is important to focus on the pathophysiologic basis for its use.