The efficacy and role of Obeticholic acid

Obeticholic acid (Obeticholic acid) is mainly used to treat primary biliary cholangitis. It is a bile acid analog and farnesoidX receptor agonist (FXR). FXRs mainly regulate hepatic triglyceride synthesis, fibrosis, and various other metabolic pathways in hepatocytes. This major pathway inhibits bile acid synthesis in hepatocytes. FXRs in hepatocytes are also activated by circulating bile acids to stimulate the bile salt export pump (BSEP) to increase bile salt excretion.

Obeticholic acid is metabolized in the liver and conjugated to glycine and taurine, which are subsequently secreted into the bile and absorbed in the small intestine. Obeticholic acid selectively binds to and activates fxr in enterocytes and hepatocytes, thereby reducing the liver and bile ducts to toxic levels of bile acids. Compared with naturally occurring bile acids, its binding capacity is more than 100 times, effectively weakening the harmful effects of bile acids on liver tissue. Obeticholic acid also directly stimulates BSEP to reduce circulating bile salts in the liver and bile tree. By reducing the liver's exposure to bile acids, it limits the progression of cholangitis processes such as primary biliary cholangitis (PBC) and PSC.

The original drug of obeticholic acid has not yet been marketed in the country, so it has not been included in medical insurance. The original obeticholic acid drug marketed overseas is expensive, with each box costing around tens of thousands of yuan. The price is also affected by exchange rates and is unstable. It is understood that obeticholic acid has been produced as a generic drug and its ingredients are basically the same as those of the original drug. For example, the price of 5mg*30 tablets produced by a Bangladesh pharmaceutical factory is around RMB 1,000 per box (the price may fluctuate due to the exchange rate), and the price is cheap. For more drug information and specific prices, please consult a medical consultant.