How Bylvay works
What happens in a healthy liver
In a healthy liver, bile acids drain from the liver to the small intestine. Up to 95% of the bile acids are then recycled back to the liver by the IBAT.
Bile acids are created in the liver. Bile acids aid in digestion, breaking down food and helping the body absorb fat-soluble vitamins.
The ileal bile acid transporter, or IBAT, recycles bile acids back to the liver from the intestines.
How Alagille syndrome affects the liver
- Bile acids don’t drain properly out of the liver to the small intestine.
- Bile acids build up to a level that may be harmful to the liver.
- Excess bile acids can spill into the bloodstream.
The buildup of bile acids in the liver and the bloodstream may be the cause of itch (cholestatic pruritus) in Alagille syndrome.
The buildup of bile acids in the liver and the bloodstream may be the cause of itch (cholestatic pruritus) in Alagille syndrome.
Bylvay inhibits the IBAT and decreases bile acid recycling back to the liver
These bile acids then leave the body naturally as waste.
While the exact way Bylvay reduces itch isn’t fully understood, IBAT inhibition may reduce bile acid buildup as measured by bile acid in the blood.