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Cholesterol 7-hydroxylase (CYP7A1) is the rate-limiting enzyme in the classical bile acid synthesis pathway, metabolizing approximately 90% of cholesterol daily ( 3.2.3 Bile acid enterohepatic circulation and regulation of nutrient absorption The enterohepatic circulation of bile acids represents a core pathway connecting intestinal and hepatic metabolism

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The licensing of oral semaglutide provided a step forward in type 2 diabetes management for this group, and the publication of the SOUL study in 2025 reassured us that oral semaglutide could also offer cardiovascular benefit in those at highest risk