Can obeticholic acid reverse cirrhosis?

Obeticholic acid is a synthetic hepatobiliary acid drug mainly used to treat primary biliary cholangitis (PBC). It regulates bile acid metabolism by activating the liver's nuclear receptor (FXR, farnesoid X receptor), thereby improving liver function. Obeticholic acid is particularly suitable for patients with PBC who have poor response to ursodeoxycholic acid (UDCA) or who cannot tolerate UDCA.

Although obeticholic acid has shown significant efficacy in the treatment ofPBC, especially in controlling bile acid levels, reducing liver inflammation, and promoting liver function recovery, it is not a reversal drug for cirrhosis. The mechanism of action of obeticholic acid is mainly to alleviate liver damage caused by cholestasis by reducing the bile acid burden on the liver. Therefore, it is of great significance to improving liver function, alleviating symptoms and delaying disease progression in patients with PBC.

However, regarding whether obeticholic acid can reverse existing cirrhosis, current clinical data do not support its ability to completely reverse the pathological changes of cirrhosis. Cirrhosis is an irreversible disease usually caused by long-term liver damage, inflammation and fibrosis. Obeticholic acid plays a more important role in delaying disease progression, alleviating symptoms, and slowing down the progression of fibrosis in patients with PBC, rather than completely reversing liver cirrhosis.

For PBC patients with cirrhosisThe use of obeticholic acid is still limited, especially for those patients with portal hypertension, the use of obeticholic acid needs to be cautious. Obeticholic acid is indicated for treatment of patients with compensated cirrhosis without portal hypertension and often requires close monitoring of the patient's liver function and other related indicators.

In summary, obeticholic acid has shown important clinical value in the treatment of PBC, especially for patients who have poor response to traditional therapies (such as UDCA), but it cannot reverse existing cirrhosis.

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