Abstract
Lifestyle modifications and optimization of the management of cardiometabolic comorbidities
are currently the mainstay of treatment for patients with nonalcoholic fatty liver
disease. Pharmacotherapy to halt or reverse hepatic histological injury and prevent
the development of end-stage liver disease is specifically offered to patients with
nonalcoholic steatohepatitis (NASH) and those with advanced fibrosis. In this review,
the authors discuss the state of the art of various pharmacological agents for NASH.
The efficacy of vitamin E and pioglitazone is reasonably well established in a selected
group of patients with NASH. Current data do not offer convincing evidence for efficacy
of pentoxifylline, long-chain polyunsaturated fatty acids, angiotensin receptor blockers,
metformin, or ursodeoxycholic acid. They also discuss the state of several emerging
agents for treating NASH including the farsenoid X receptor ligand, obeticholic acid.
Keywords
nonalcoholic fatty liver disease - nonalcoholic steatohepatitis - vitamin E - thiazolidinedione
- obeticholic acid