Treatment of resistance to obeticholic acid

Obeticholic acid (Obeticholic acid) is a drug used to treat primary biliary cholangitis (PBC). Although obeticholic acid is effective in reducing symptoms and improving patients' quality of life, sometimes patients may become resistant to it. Following oral administration of 10 mg of obeticholic acid once daily, peak plasma cholic acid concentrations (Cmax) occur at a median time of approximately 1.5 hours (Tmax). The average Tmax for glycoconjugates and taurine conjugates of cholic acid was 10 hours.

Taking it with food does not alter the extent of obeticholic acid absorption. Sometimes increasing the dose of obeticholic acid can help overcome resistance, but this needs to be done under the guidance of a doctor and the patient needs to be monitored for response and side effects. Combining obeticholic acid with other medications may increase the effectiveness of treatment. For example, using obeticholic acid with a bile acid-binding resin may increase the effectiveness of treatment by taking obeticholic acid at least 4 hours before or 4 hours after taking the bile acid-binding resin, or as far apart as possible.

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.