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[Correspondence] Trials of obeticholic acid for non-alcoholic steatohepatitis

We read with interest the results of the FLINT trial (March 14, p 956)1 that investigate the effect of obeticholic acid on liver histology in non-alcoholic steatohepatitis. A remarkable yet overlooked result in the appendix of this trial was the difference in histological response between participants with diabetes and those without: for participants with diabetes, liver histology improved in 53% of patients who received obeticholic acid versus 19% for placebo (odds ratio [OR] for improvement with obeticholic acid 4·6, 95% CI 2·0–10·6, p=0·0003), while for patients without diabetes, liver histology improved in 37% patients with obeticholic acid versus 23% with placebo (OR 2·0, 95% CI 0·8–4·7, p=0·12).