Novel Therapies for Nonalcoholic Steatohepatitis (NASH) and Cardiovascular Risk Reduction.

Abstract

Nonalcoholic steatohepatitis (NASH) is a type of nonalcoholic fatty liver disease (NAFLD) characterized by hepatocyte injury and inflammation, in addition to only the presence of steatosis NAFLD. We review the existing data on available novel therapies for NASH and NAFLD and also discuss several therapies in development. We assessed therapies for NASH by searching the databases of PubMed, EMBASE, and Web of Science (SCI) from their inception dates until September 15, 2024. Search terms used were: nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, liver inflammation and hepatocyte injury.Until very recently, therapeutic lifestyle change was the primary modality of treatment for NASH, including modification of diet and physical activity. The FDA recently approved resmetirom using its expedited approval mechanism for NASH. There are also several pharmacotherapies in development for NASH which aim at weight loss, insulin sensitization and improvement in lipid levels, although some drugs may have multiple effects which are discussed. The availability of resmetirom offers patients with NASH an effective adjunctive therapy in addition to lifestyle changes. Several other novel therapies are also currently being tested and will add to our therapeutic armamentarium.