The high response rate to treatment with IBAT (odevixibat) in these patients suggests that in PFIC4, despite tight junction dysfunction, there is a regular passage of BAs from the hepatocytes to the biliary tree and the bowel, allowing odevixibat to interrupt the enterohepatic circulation and decrease the recirculating BA pool [1, 42, 47]
The patient has already trusted the provider with one protocol
Schiattarella GG, Rodolico D, Hill JA (2021) Metabolic inflammation in heart failure with preserved ejection fraction
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Future studies will also need to assess the effects of semaglutide on alcohol craving and consumption at higher medication doses and with people with severe alcohol use disorder
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