This study aims to find out how safe and effective the investigational drug (also called a study drug) "obeticholic acid" (also known as OCA) may be in improving compensated cirrhosis caused by Nonalcoholic Steatohepatitis (NASH).

This study has two parts:

Part 1 is called the Double-Blind phase because neither the participant nor the doctor will know if the participant is receiving the study drug (OCA) or placebo (dummy pill).

Part 2 is called the Open-Label Extension phase because all participants will receive the study drug (OCA), and no one will receive a placebo.

This study is currently closed to enrollment.

1. Subjects with a confirmed diagnosis of NASH and a fibrosis score of 4 based upon the NASH CRN scoring system determined by central reading

Key exclusion criteria:

1. Current or past history of a clinically evident hepatic decompensation event, such as ascites, hepatic encephalopathy (HE), or variceal bleeding
2. Current or past history of CP score ≥7 points
3. Model for End-stage Liver Disease (MELD) score > 12
4. ALT ≥ 5 X ULN
5. Calculated creatinine clearance <60mL/min using Cockcroft-Gault method
6. Hemoglobin A1c (HbA1c) ≥ 9.5 %
7. Evidence of other known forms of chronic liver disease such as alcoholic liver disease, hepatitis B, hepatitis C, PBC, PSC, autoimmune hepatitis, Wilson disease, iron overload, alpha-1-antitrypsin deficiency, drug-induced liver injury, known or suspected hepatocellular carcinoma (HCC)
8. History of liver transplant, or current placement on a liver transplant list