A real-world retrospective analysis of 178 US patients with Alagille syndrome found that maralixibat treatment enabled 43% to discontinue at least one concomitant medication during long-term therapy. The report frames medication reduction as a clinically meaningful downstream outcome for patients managing chronic cholestatic symptoms. For clinicians and payers, the signal is about burden-of-therapy reduction rather than only biochemical targets, aligning with a growing emphasis on functional and medication-sparing endpoints. The findings also reinforce that lipid-directed bile acid pathway modulation can affect multiple aspects of disease management beyond a single lab marker.