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Although current evidence supports broad applicability across BMI, diabetes status, and fibrosis stages F2-F3, subgroup analyses suggest attenuated responses in non-obese patients and in certain ethnic groups (Hispanic patients in ESSENCE), emphasizing the need for precision medicine approaches incorporating anthropometric, genetic (e.g., PNPLA3, HSD17B13), and metabolic profiling

Nuclear receptor agonists, particularly FXR modulators, have demonstrated efficacy in attenuating bile acid cytotoxicity, enhancing hepatobiliary excretion, and mitigating bilirubin accumulation [54]