Hormonal
Activation of the bile acid receptor FXR using agonists like Obeticholic Acid (OCA) improves liver histology (NAFLD Activity Score and fibrosis) in patients with NASH, though it may negatively impact lipid profiles by increasing LDL and decreasing HDL cholesterol.
If you have NASH, your doctor might prescribe Obeticholic Acid (25mg daily) to improve liver scarring and inflammation. Be aware that this medication often raises LDL cholesterol and lowers HDL, so your lipid levels will need close monitoring. It resolves NASH in about 1 in 5 patients, so it is not a guaranteed cure but a tool to manage disease progression.
Treatment with OCA significantly improved the primary histological outcome (i.e. improvement of the NAFLD Activity Score [NAS]) and led to a significant reduction of liver fibrosis compared to those of patients treated with placebo... Patients receiving OCA also exhibited increased total serum cholesterol and LDL-cholesterol levels and a modest, but significant, reduction in HDL-cholesterol.
Why this rating
Based on Phase II clinical trials (FLINT trial) which are promising but limited in scope and duration compared to Phase III or long-term outcomes.
Source
Bile acids and nonalcoholic fatty liver disease
Juan Pablo Arab et al. · Hepatology · 2016
DOI 10.1002/hep.28709
More from this paper
- Activation of the bile acid receptor TGR5 (GPBAR1) increases energy expenditure and thermogenesis in brown adipose tissue and muscle, and stimulates GLP-1 release to improve glucose tolerance.Moderate
- Gut microbiota composition influences bile acid pool size and signaling, where germ-free mice are resistant to high-fat diet-induced obesity and NASH due to altered FXR signaling and larger bile acid pools.Limited
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