Mechanism of action

Seladelpar activates PPAR‑δ, a nuclear receptor expressed in the liver and other tissues.
PPAR‑δ activation:

Reduces bile acid synthesis via FGF21‑mediated downregulation of CYP7A1, the rate‑limiting enzyme in bile acid production
Decreases cholesterol synthesis and absorption
Lowers hepatic and circulating bile acid levels


These effects result in:

Reduced cholestatic liver injury
Improvement in biochemical markers (e.g., alkaline phosphatase)
Reduction in pruritus, partly associated with decreased interleukin‑31 levels

Indication

Approved indication (FDA / EMA):

Treatment of primary biliary cholangitis (PBC) in adults:

In combination with ursodeoxycholic acid (UDCA) in patients with inadequate response to UDCA, or
As monotherapy in patients unable to tolerate UDCA