The potent fenalilide X receptor (FXR) agonists, animal experiments, in the liver, kidneys and small intestines in the anti-inflammatory, anti-fibrosis effect is 100 times the chenodeoxycholic acid. In the NASH-FLINT study, the histological response rate (NAS drop> 2 points) was higher than that of the control group at 72 weeks, with no increase in hepatic fibrosis. But its itching, abnormal side effects of dyslipidemia, Oberbile acid group, there are 2 cases died of heart failure and myocardial infarction. At present, oberic acid has entered phase 3 clinical trials. Other FXR-based therapies are still in preclinical or clinical phase 1 or 2.
PPARs has a wide range of nuclear receptor superfamily effects, including regulation of lipid, glucose and energy metabolism, and inhibition of inflammatory pathways (especially anti-NF-κB activation kappa). Major subtypes (αPPAR ligands, δ, and γ). But the fibrate drugs, as α prototype PPAR agonists, in the treatment of NAFLD experimental results are disappointing. The current research focuses on double PPAR agonists such as α /δ as elafi branor (Luce, France). This drug in the preclinical and 2 trials of anti-inflammatory, anti-fibrosis, metabolic regulation is encouraging. If this drug is mainly due to PPAR-δ play a role in the development of other pure PPAR-δ agonists (such as δMBX-8025) will cause people's interest.