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Science & Medicine

Scientific Focus

Bile Acid Modulation

Albireo is the leader in bile acid science and is leveraging its expertise in bile acid modulation to bring novel, potentially transformative medicines to patients.

Based on mechanism of action and over a decade of gold standard R&D, we believe bile acid modulation with IBAT inhibition and other novel mechanisms may benefit people with a wide range of cholestatic liver diseases.


When the flow of bile from the liver is disrupted in cholestasis, bile acids accumulate in the liver and potentially spill over into the blood. Elevated bile acid levels in the liver and serum are primary characteristics of cholestatic liver diseases and have been linked to severe pruritus. Ileal bile acid transporters inhibitors (IBATi) decrease the reabsorption of bile acids and thus, may reduce serum bile acids.


Apical sodium-dependent bile acid transporter inhibitors (ASBTi) not only inhibit bile acid uptake in the intestine but, as shown in preclinical models, also inhibit bile acid re-uptake in the kidney. Thus, ASBTi is differentiated from the locally-in-the-gut active bile acid transport inhibitors and should increase bile acid output by both fecal and urinary excretion.


Na+ taurocholate co-transporting polypeptide inhibitors (NTCPi) only work in the liver and inhibit bile acid re-uptake to the liver by directly avoiding the ileum altogether. NTCPi are earlier in development, but may be a way to treat cholestatic liver diseases as well as Hepatitis B and D. These viruses use NTCP as an entry mechanism into the hepatocytes.

For more on our scientific programs, see our Pipeline.


Bylvay® (odevixibat) is approved for the treatment of pruritus in PFIC in the U.S. and for PFIC in Europe. Elobixibat is approved for chronic constipation in Japan and Thailand. All other drugs and indications are currently investigational.