A Review of Pharmacological Treatments of NASH

Background: Non-alcoholic fatty liver disease (NAFLD) encompasses the entire spectrum of fatty liver disease in individuals without significant alcohol consumption and affects up to a third of the population in many developed countries. Approximately 10-30% of patients with NAFLD will progress to non-alcoholic steatohepatitis (NASH), which is associated with hepatocellular injury and inflammation resulting in progressive liver fibrosis, liver failure and liver cancer. The increase in the number of patients with advanced liver disease secondary to NASH, as well as associated hepatocellular carcinoma, will impact on the potential future demand for Liver Transplantation (LT) and also increase the cardiovascular mortality. Despite these large numbers of pharmacological agents that have been used to treat NASH, none of them have yet been shown to improve clinically meaningful outcomes. Also the long term safety of several agents remain to be established.