TheraRadar
Data updated: May 26, 2026

CHOLBAM (cholic acid)

Trial Activity: Declining
Hepatology Approved 2015-03-17

CHOLBAM is indicated for the treatment of Bile Acid Synthesis Disorders; Peroxisomal Disorders; Zellweger Spectrum Disorders; Liver Disease; Steatorrhea.

Source: FDA Label • MIRUM • Bile Acid

How CHOLBAM Works

Cholic acid is an endogenous primary bile acid that addresses deficiencies resulting from biosynthetic pathway defects. In SEDs and PDs, the lack of primary bile acids leads to the accumulation of toxic intermediate bile acids and cholestasis. Cholic acid acts as a ligand for the farnesoid X receptor (FXR), which provides physiologic feedback inhibition of bile acid synthesis, thereby reducing the production of harmful intermediates. Furthermore, it restores the formation of mixed micelles in the intestine, facilitating the digestion and absorption of dietary fats and fat-soluble vitamins.

Development Insights

Mirum Pharmaceuticals, Inc. conducting 2 trials (67%)
3 indications explored (Focused)
smith-lemli-opitz syndrome (1 trials)
bile acid synthesis defect (1 trials)
inborn errors of bile acid synthesis (1 trials)
1
Indication
--
Phase 3 Trials
1
Priority Reviews
11
Years on Market

Details

Status
Prescription
First Approved
2015-03-17
Routes
ORAL
Dosage Forms
CAPSULE

Companies

Active Ingredient: CHOLIC ACID

CHOLBAM Approval History

2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
4 FDA actions from 2015 to 2020
Oct 2020 SUPPL
Label · Labeling
Mar 2015 ORIGINAL Priority
New Drug · Type 1 - New Molecular Entity

What CHOLBAM Treats

5 indications

CHOLBAM is approved for 5 conditions since its original approval in 2015. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Bile Acid Synthesis Disorders
  • Peroxisomal Disorders
  • Zellweger Spectrum Disorders
  • Liver Disease
  • Steatorrhea
Source: FDA Label

CHOLBAM Competitive Set

Pro

Three rings of competition based on shared molecular targets and treated indications.

MoA expansion candidates

2

Same target(s), different indications — where else is this mechanism being explored?

Indication competitors

1

Same indication, different mechanism — what else might this patient receive?

Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.

Drugs Similar to CHOLBAM

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ELCYS
CYSTEINE HYDROCHLORIDE
1 shared
EXELA PHARMA
Shared indications:
Liver Disease
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Clinical Trial Registry

3 trials
Trial Sponsor ID Phase Status Title
NCT03720990 results posted 0464-18-FB Ph 1, Ph 2 completed Smith-Lemli-Opitz Syndrome and Cholic Acid
NCT01115582 results posted CAC-001-01 Ph 3 completed Efficacy of To Be Marketed (TBM) Cholic Acid Capsules Used to Treat Children With Inborn Errors of Bile Acid Synthesis
NCT01438411 results posted CAC-002-01 Ph 3 completed Open Label, Continuation Study of Cholic Acid in Subjects With Inborn Errors of Bile Acid Synthesis
🔬

Active Pipeline

Pro

Ongoing clinical trials by development phase

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Key Completed Trials

Pro

Completed studies with published results, ranked by significance

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

CHOLBAM FDA Label Details

Indications & Usage

FDA Label (PDF)

CHOLBAM is indicated for the treatment of Bile Acid Synthesis Disorders; Peroxisomal Disorders; Zellweger Spectrum Disorders; Liver Disease; Steatorrhea.

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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.

How We Calculate These Metrics

Trial Activity Stage

Measures the current development activity pattern based on trial phases, status, and trends. Important: This measures R&D activity, not commercial lifecycle.

Trial statuses: "Active" means recruiting or ongoing. "Completed" means reached planned endpoint. "Terminated" means stopped early—often due to safety, efficacy, or business reasons.

  • Growth: High proportion of early-phase trials (Phase 1/2), active development
  • Expansion: Significant Phase 3 activity, approaching or pursuing approvals
  • Mature: Substantial Phase 4 post-marketing studies
  • Stable: Mixed phase distribution, steady development
  • Declining: Low active trial ratio, reduced R&D investment