aldafermin

Aldafermin, formerly known by the development code NGM282, is a synthetic, nonsteroidal agonist of the farnesoid X receptor (FXR). FXR is a nuclear receptor that regulates bile acid, lipid, and glucose metabolism. By activating FXR signaling, aldafermin aims to restore bile acid homeostasis and reduce hepatic fat accumulation, inflammation, and fibrosis.

In clinical development, aldafermin has been investigated for liver diseases such as nonalcoholic steatohepatitis (NASH) and primary sclerosing cholangitis (PSC). It has progressed through phase 2 trials to assess effects on liver histology, fat content, and serum biomarkers. Results across studies have shown activity in some endpoints and patient subsets, but a consistent demonstration of efficacy sufficient for regulatory approval has not been established. Development status has included ongoing trials and, in some cases, strategic adjustments by sponsors based on interim findings.

Safety and tolerability data from trials indicate that adverse events commonly associated with FXR agonists—such as gastrointestinal symptoms and pruritus—were observed in a subset of participants, with frequency and severity varying by dose and study design.

Aldafermin is positioned as part of a broader class of FXR-targeted therapies and reflects ongoing efforts to modulate bile acid signaling as a strategy for liver disease treatment. The future of its development depends on results from ongoing or future clinical investigations and regulatory review.