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This combination therapy consists of odevixibat (A4250) and a proprietary colonic-release formulation of cholestyramine (A3384). Odevixibat is a potent, small molecule inhibitor of the ileal bile acid transporter (IBAT), also known as the apical sodium-dependent bile acid transporter (ASBT). By blocking the reabsorption of bile acids in the distal ileum, odevixibat reduces the systemic bile acid pool and alleviates symptoms of cholestasis, such as severe pruritus. Colonic-release cholestyramine (CRC) is a bile acid sequestrant designed to release specifically in the colon to further reduce bile acid levels while minimizing the gastrointestinal side effects and drug-drug interactions typically associated with standard cholestyramine formulations. Developed by Albireo Pharma (now part of Ipsen), this combination has been investigated in Phase 1 trials for the treatment of rare pediatric and adult cholestatic liver diseases, including progressive familial intrahepatic cholestasis (PFIC), Alagille syndrome, and primary biliary cholangitis (PBC).
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