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Cilofexor is a nonsteroidal small molecule agonist of the farnesoid X receptor (FXR), developed primarily for the treatment of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). It has also been investigated for primary sclerosing cholangitis (PSC) and, to a lesser extent, primary biliary cholangitis/cirrhosis. Cilofexor acts by activating FXR, which regulates bile acid synthesis and transport, leading to reduced hepatic inflammation and fibrosis. In preclinical models and clinical trials, cilofexor demonstrated anti-inflammatory and antifibrotic effects, reducing liver fibrosis markers as well as improving biochemical indicators of liver injury. The drug was originally discovered by Phenex Pharmaceuticals and further developed by Gilead Sciences[3][5][7].
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