Odevixibat Improves Itch After Maralixibat Switch in ALGS
Adolescent Alagille Patients Find Relief After Therapy Switch
Three adolescent patients with Alagille syndrome experienced improvements in severe chronic itching after switching their treatment from maralixibat to odevixibat, HCPLive reported.
Weighing Side Effects Against Chronic Itch
Two adolescents stopped taking maralixibat because of gastrointestinal side effects. A third stopped due to poor adherence alongside uncontrolled pruritus.
All three patients reported itch improvement after transitioning to odevixibat.
Diarrhea and abdominal pain emerged in two patients receiving odevixibat. These symptoms resolved without requiring treatment discontinuation.
Transitioning Patients Between Odevixibat and Maralixibat Therapies
The findings provide preliminary real-world data on switching therapies following randomized evidence from the ASSERT clinical trial, published in The Lancet Gastroenterol Hepatol. While the ASSERT trial demonstrated improvements in scratching scores and serum bile acids with odevixibat compared with placebo, that study did not evaluate patients transitioning directly from maralixibat.
N. Ovchinsky noted that adolescence represents a vulnerable developmental window where chronic symptoms compound everyday school and social pressures. Adult hepatologists stepping in to manage these patients should understand the adverse effects linked to ileal bile acid transporter inhibitors, proper dose optimization, and when switching medications makes clinical sense.
Disclaimer: The Information Provide
The retrospective analysis of three adolescents cannot establish definitive comparative efficacy or tolerability between the two medications. Ovchinsky emphasized the necessity of individualized treatment strategies and longer follow-up periods. These measures are required to determine whether targeted therapies genuinely alter liver disease prognosis beyond mere symptom control while defining long-term safety profiles.
The observations were presented at The Liver Meeting 2026 in Denver, Colorado. Ovchinsky reported no relevant financial disclosures of note.
Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.