Table 2.

Bile Acid–Based Therapies

Bile acids

CA (Cholbam) and CDCA (Chenodiol): treat inborn errors of bile acid synthesis; gallstone dissolution

UDCA (ursodiol [Actigall]): gallstone dissolution; reduces bile acid cytotoxicity

NorUDCA: PSC

Bile acid sequestrants

Cholestyramine, colesevelam: gallstone dissolution; reduces bile acid pool and stimulates bile acid synthesis; decreases FGF19; activates TGR5/GLP‐1 and improves glycemic control; stimulates thermogenesis in brown adipose tissue

FXR agonists: anti‐inflammation, cholestasis, NASH fibrosis, diabetes, obesity

Obeticholic acid (OCA, OCALIVA): PBC

Fexaramine (intestine‐restricted FXR agonist): stimulates adipose tissue browning, stimulates GLP‐1 secretion, improves insulin sensitivity, and reduces weight

FXR antagonists (intestine): PBC; reduces weight, improves diabetes

Glycoursodeoxycholic acid, glycine‐β‐muricholic acid

FGF19 analogue (NGM282): anti‐inflammation and fibrosis; PSC, PBC, and NASH