Editing Primary biliary cholangitis (section)

===== Obeticholic acid =====
[[Obeticholic acid]] (OCA) is FDA-approved for the treatment of PBC in individuals intolerant or unresponsive to UDCA.<ref name="AASLD_2018" /> OCA is a [[farnesoid X receptor]]  agonist, and results in increased bile flow ([[Choleretic|choleresis]]). OCA is started at 5&nbsp;mg daily, and liver chemistries should be rechecked after 3 months of treatment. If the liver chemistries remain elevated,{{Contradictory inline|reason=Wouldn't the dose need to be adjusted down if liver enzymes were increased?|date=April 2025}} then the dose of OCA may be increased to 10&nbsp;mg per day. The most common side effect of OCA is [[pruritus]].{{Citation needed|date=April 2025}}

In December of 2024, the FDA expanded upon an initial warning from 2021 about potential [[Liver disease|liver damage]] from OCA. Obeticholic acid has been found to increase incidence of severe liver disease in patients taking it, and patients taking OCA without pre-existing liver damage have been found to require liver transplantation at higher rates than similar patients taking a [[placebo]]. As a result, the use of OCA in patients with known [[cirrhosis]] is heavily cautioned.<ref>{{Cite journal |last=U.S. Food and Drug Administration |date=2024-12-12 |title=Ocaliva (obeticholic acid) by Intercept Pharmaceuticals: Drug Safety Communication - Serious Liver Injury Being Observed in Patients without Cirrhosis |url=https://www.fda.gov/safety/medical-product-safety-information/ocaliva-obeticholic-acid-intercept-pharmaceuticals-drug-safety-communication-serious-liver-injury |journal=FDA |language=en |archive-url=https://archive.today/20250424230427/https://www.fda.gov/safety/medical-product-safety-information/ocaliva-obeticholic-acid-intercept-pharmaceuticals-drug-safety-communication-serious-liver-injury |archive-date=2025-04-24}}</ref>