colesevelam / Generic mfg. - LARVOL DELTA

Colesevelam increases ileal L cell density and GLP-1 secretion to improve glucose tolerance in high-fat diet-induced obese mice (EASD 2026) - "Short-term colesevelam treatment improves glucose tolerance in diet-induced obese mice, accompanied by increased ileal L-cell density and enhanced BA-evoked GLP-1 secretion."

Preclinical • Diabetes • Metabolic Disorders • Obesity • Type 2 Diabetes Mellitus

Lenalidomide-related diarrhea is associated with gut microbiota dysbiosis and disruption of the bile acid pool (ASH 2025) - P2 | "Symptom responsiveness to BA binders (colesevelam)has been described (PMID: 39300066), but the underlying mechanism of LRD is not known. We reveal primaryBA enrichment in patients with LRD, which correlated with disrupted microbial processing capacity. Thesedata suggest that beyond bile acid sequestration, strategies to improve gut microbial diversity andfunctional capacity may warrant further study for mitigation of LRD."

Dysbiosis • Gut Microbiota • Gastrointestinal Disorder • Hematological Malignancies • Multiple Myeloma

Circulating levels of PYY are increased in individuals with bile acid diarrhoea. (PubMed, J Clin Endocrinol Metab) - "Collectively, these results suggest a role for PYY as a marker for BAD pathophysiology and warrant further studies into the role of PYY in BAD and other diarrhoeal diseases."

Journal

More or less? Bile acids and glycaemic control in type 2 diabetes (ANZCTR) - P1 | N=25 | Active, not recruiting | Sponsor: The University of Adelaide | Recruiting ➔ Active, not recruiting

Enrollment closed • Diabetes • Metabolic Disorders • Type 2 Diabetes Mellitus

Real-world use of SeHCAT scanning and bile acid sequestrants in chronic diarrhoea: a retrospective NHS study (BSG 2026) - "Colesevelam is better tolerated compared to cholestyramine as reflected by treatment switching. These findings highlight the need for more defined diagnostic pathways for chronic diarrhoea and prospective comparative studies evaluating tolerability and effectiveness of bile acid sequestrants to establish treatment guidelines."

Real-world • Real-world evidence • Retrospective data • Infectious Disease • ELANE

Comparison chart: Some non-statin lipid-lowering drugs. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal

Drugs for hypercholesterolemia. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Dyslipidemia • Metabolic Disorders

PAVERS: Use of Bile Acid Binding Resins to Decrease PFAS Levels Via Colesevalem in Veterans Study (clinicaltrials.gov) - P2 | N=50 | Not yet recruiting | Sponsor: University of Rhode Island

New P2 trial • Dyslipidemia • Metabolic Disorders • Mixed Hyperlipidemia

DETECTING SAFETY SIGNALS OF BILE ACID THERAPEUTICS: A FDA FAERS-BASED PHARMACOVIGILANCE STUDY (ISPOR 2026) - "Chenodiol (Ctexli), a synthetic bile acid, recently repurposed to treat cerebrotendinous xanthomatosis (CTX) in adults, has a limited well-defined real world safety data...Safety signals were evaluated using established criteria based on the reporting odds ratio (ROR) and proportional reporting ratio (PRR), each with 95% confidence intervals, along with the chi-square statistic (χ²) and p-values, with signals defined as ROR and PRR > 2, a lower 95% CI bound > 1, χ² ≥ 3, and p < 0.005. Disproportionality analysis identified potential safety signals associated with chenodiol, cholestyramine, colesevelam, and colestipol... Chenodiol's recent approval for cerebrotendinous xanthomatosis exemplifies how existing medications can be re-evaluated for new indications, and other therapeutic options. Integrating real-world safety data from post-marketing surveillance is crucial to supporting these repurposing efforts and ensuring patient safety."

Adverse events • Clinical

Bile acid detergency as determinant of liver pathology in a humanized mouse model of progressive familial intrahepatic cholestasis type 3. (PubMed, Cell Mol Gastroenterol Hepatol) - "The presence of a human-like BA composition profoundly aggravates liver pathology upon Abcb4 reduction in mice, conceivably due to the augmented extrusion of non-PC phospholipids by hydrophobic BAs from membranes into bile. This humanized PFIC3 model is anticipated to accelerate the development of novel therapies for PFIC3 and potentially other cholestatic liver diseases."

Journal • Preclinical • Cholestasis • Fibrosis • Hepatology • Immunology • Liver Cirrhosis • ABCB4

F106-CT01: Efficacy and safety of a novel dual pH-dependent delayed-release ColeseveLam for the trEatment of bile Acid diarrhoea: a Randomized, double-blind, parallel-group, placebo-controlled clinical trial CLEAR (clinicaltrialsregister.eu) - P1/2 | N=50 | Not yet recruiting | Sponsor: Monteresearch S.r.l.

New P1/2 trial

AGGRESSIVE LIPID LOWERING IN HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA: 29 YEARS EVENT-FREE SURVIVAL AFTER PREMATURE STEMI (ACC 2026) - "He began atorvastatin 20 mg plus ezetimibe 10 mg and colesevelam (6 × 625 mg daily)...In 2018, evolocumab 140 mg q2w was added and ezetimibe stopped, dropping LDL-C to 0-20 mg/dL... Intensive lipid lowering in HeFH can alter disease trajectory. In the pre-stent era, pharmacologic LDL-C reduction became a "revascularization strategy," providing nearly thee decades of event-free survival.Early and sustained LDL-C lowering in HeFH can prevent recurrent ischemic events and promote durable clinical stability, underscoring the critical role of aggressive lipid management in secondary prevention."

Coronary Artery Disease • Dyslipidemia • Familial Hypercholesterolemia • Genetic Disorders • Heterozygous Familial Hypercholesterolemia • Metabolic Disorders

Examining a Novel Gastrointestinal Intervention to Negate Environmental Toxicants (ENGINE) (clinicaltrials.gov) - P1/2 | N=40 | Recruiting | Sponsor: University of California, San Francisco | Not yet recruiting ➔ Recruiting

Enrollment open

Lipid-Lowering Therapy Is Underutilized Across LDL-C Levels in Autoimmune Disease Compared to Diabetes: A Nationwide Analysis (AHA 2025) - "Statins included atorvastatin, rosuvastatin, simvastatin, pravastatin, lovastatin, fluvastatin, pitavastatin. Non-statin therapies included icosapent ethyl, colesevelam, alirocumab, evolocumab, Bempedoic acid, cholestyramine, Inclisiran, colestipol, ezetimibe, gemfibrozil, omega-3 acid, fenofibrate...Non-statin lipid-lowering therapy use was significantly lower in autoimmune patients compared to those with diabetes across all LDL-C tertiles, with the largest differences observed at LDL <70 mg/dL (6.19% vs 10.24%, p<0.0001) and 70–99 mg/dL (4.05% vs 7.06%, p<0.0001).ConclusionDespite comparable ASCVD risk, patients with autoimmune disease are significantly less likely to receive statins or non-statin lipid-lowering therapy than those with DM across LDL-C levels. These findings show a need for improved cardiovascular prevention in this high-risk population."

Atherosclerosis • Cardiovascular • Diabetes • Dyslipidemia • Hepatology • Immunology • Inflammatory Arthritis • Lupus • Metabolic Disorders • Rheumatoid Arthritis • Rheumatology • Systemic Lupus Erythematosus

Bile Acid Binding Resins Improve Glucagon Receptor Agonist-Mediated Weight Loss in Diet-Induced Obese Mice. (PubMed, Obesity (Silver Spring)) - "Together, these studies suggest that BARs enhance the antiobesity effect of GCGR agonism in DIO mice, representing a novel antiobesity strategy."

Journal • Preclinical • Genetic Disorders • Obesity

Examining a Novel Gastrointestinal Intervention to Negate Environmental Toxicants (ENGINE) (clinicaltrials.gov) - P1/2 | N=40 | Not yet recruiting | Sponsor: University of California, San Francisco

New P1/2 trial

Refractory Collagenous Colitis Requiring Inpatient Infliximab Infusion (ACG 2025) - "Multiple therapies, including loperamide, diphenoxylate-atropine, budesonide, bismuth subsalicylate, cholestyramine, colesevelam, mesalamine, gluten-free diet, and recent initiation of prednisone with azathioprine for the current flare have been ineffective. Attempts to initiate outpatient biologic therapy, with infliximab or vedolizumab, were unsuccessful due to insurance denial...TPN was started and trials of octreotide and rifaximin yielded no improvement...Severity and chronicity of microscopic colitis may mimic that of inflammatory bowel disease, and biologic therapy such as TNF-α inhibitors may be used for treatment, although current knowledge is based on case reports and studies. Further research is needed to investigate the role, safety and efficacy of biologics for treating microscopic colitis, which may help streamline off-label treatments, decrease morbidity, improve barriers for initiating such medications and resource utilization."

Clinical • Cardiovascular • Celiac Disease • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Renal Disease

Bile Acid Sequestrant-Induced Hypertriglyceridemia Leading to Acute Pancreatitis: A Case Report (ACG 2025) - "Although effective for gastrointestinal symptoms, they can affect lipid metabolism and pre-dispose one to consequences of hypertriglyceridemia.Case Description/ A 58-year-old Caucasian male with a history of ileocolonic Crohn's disease status post-surgical resection on ustekinumab was prescribed colesevelam for bile acid diarrhea which provided subsequent relief. Despite this, routine triglyceride screening is not standard before initiating bile acid sequestrant therapy for bile acid diarrhea. Given the prevalence of hypertriglyceridemia and reports of pancreatitis likely triggered by bile acid sequestrants, we recommend triglyceride screening in all patients with bile acid diarrhea prior to initiating bile acid sequestrant therapy."

Case report • Clinical • Cardiovascular • Crohn's disease • Dyslipidemia • Endocrine Cancer • Gastroenterology • Gastrointestinal Disorder • Hypertriglyceridemia • Immunology • Inflammation • Inflammatory Bowel Disease • Metabolic Disorders • Pancreatitis • Severe Hypertriglyceridemia

ASSOCIATION BETWEEN PRURITUS AND HEALTHCARE UTILIZATION AND COSTS AMONG INDIVIDUALS WITH PRIMARY BILIARY CHOLANGITIS IN THE UNITED STATES (AASLD 2025) - "Subgroup analyses required pruritus treatment (sertraline, naltrexone, cholestyramine, cholestipol, rifampin, colesevelam, hydroxyzine or diphenhydramine) within ±90 days of the index date. Eligibility included age >=18, continuous enrollment for >=12 months pre- and post-index date, excluding patients receiving obeticholic acid during baseline... In a real-world study of patients with PBC, pruritus was a significant contributor to HCRU and costs. These findings highlight the need for effective management and novel therapies to alleviate pruritus and reduce its associated clinical burden and costs."

Clinical • HEOR • Alzheimer's Disease • CNS Disorders • Dementia • Depression • Dermatology • Hepatology • Immunology • Primary Biliary Cholangitis • Pruritus • Psychiatry • Sleep Disorder

A MULTI-SPECIALTY RETROSPECTIVE EVALUATION OF DIAGNOSTIC AND MANAGEMENT STRATEGIES FOR BILE ACID DIARRHOEA IN TERTIARY CARE HOSPITALS (UEGW 2025) - "Bile acid diarrhoea continues to be a prevalent factor contributing to chronic diarrhoea in healthcare. While existing treatment modalities have proven effective in managing this condition, they remain poorly tolerated. Our study confirms that colesevelam demonstrates improved tolerability compared to colestyramine."

Retrospective data • Constipation • Gastroenterology • Gastrointestinal Disorder

UTILIZATION OF SEHCAT [75SE-TAUROSELCHOLIC ACID] SCANNING FOR DIAGNOSING BILE ACID MALABSORPTION IN A UK TERTIARY REFERRAL CENTRE: AN UNDERUTILIZED DIAGNOSTIC TOOL FOR ENHANCING THE MANAGEMENT OF CHRONIC DIARRHOEA [WITHDRAWN] (UEGW 2025) - "SeHCAT scans demonstrated a diagnostic yield of 41.6% for BAM in a cohort of 334 patients, with 62.5% of assessed cases achieving a clinical response to bile acid sequestrant therapy (cholestyramine or colesevelam). These findings underscore the utility of SeHCAT scanning as a highly sensitive and specific tool for identifying BAM, a frequently underdiagnosed contributor to chronic diarrhea. Given the variability in current clinical practice and the underutilization of this diagnostic modality, integrating SeHCAT scans into standardized diagnostic algorithms for chronic diarrhea is recommended to enhance diagnostic accuracy and optimize patient outcomes."

Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease

MANAGEMENT OF BILE ACID MALABSORPTION: INSIGHTS INTO TREATMENT AND PATIENT OUTCOMES (UEGW 2025) - "Current first-line treatment involves bile acid sequestrants (eg.cholestyramine, colesevelam). Our findings highlight critical gaps in the management of BAM. Poor compliance with cholestyramine, primarily due to side effects, underscores the importance of individualized treatment plans and patient education. Furthermore, inadequate follow-up care likely contributed to suboptimal treatment outcomes."

Clinical • Urology

Serum, urinary and fecal concentrations of perfluoroalkyl substances after interventions with cholestyramine/colesevelam and probenecid - cross-over trials in Ronneby, Sweden. (PubMed, Environ Int) - "Bile acid sequestrants could be used for accelerating PFAS excretion in highly PFAS exposed individuals. Studies are needed to evaluate the risks, costs and benefits of using it for this purpose."

Journal

Management of bile acid diarrhea in Italy: a survey. (PubMed, Intern Emerg Med) - "BAD diagnosis was assessed with 75SeHCAT (67.8% of gastroenterologists and 51.4% of other physicians), followed by a trial of cholestyramine (30.5% of gastroenterologists and 31.4% of other physicians)...75SeHCAT availability influences the awareness of this disease. Therapies currently are often not able to guarantee adequate symptom relief."

Journal • Gastrointestinal Disorder

Fecal and Clinical Profiles of Dogs With Chronic Enteropathies Treated With Bile Acid Sequestrants for 5-47 Months: A Retrospective Case Series. (PubMed, J Vet Intern Med) - "Treatment with BAS as adjunctive treatment potentially may benefit some dogs with nonresponsive or partially immunosuppressive-responsive enteropathy or CE dogs requiring high doses of corticosteroids."

Journal • Retrospective data • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Metabolic Disorders