Diabetes, hypertension, and elevated transaminases are drivers of fibrosis progression in patients with nonalcoholic steatohepatitis (NASH). F1 patients with comorbidities are at a higher risk of rapid progression to advanced fibrosis. In REGENERATE, an ongoing, double-blind, placebo (PBO)-controlled study, results of the 18-month interim analysis showed that obeticholic acid (OCA) improved liver fibrosis in F2/F3 patients.1 This secondary analysis assessed the effect of OCA in patients with fibrosis due to NASH including those with early fibrosis but at risk of disease progression.