[Drug therapy for non-alcoholic steatohepatitis]

Nonalcoholic steatohepatitis (NASH) once considered a benign process is now known to lead to progressive fibrosis and cirrhosis. NASH is frequently associated with the metabolic syndrome. Gradual weight reduction and increased physical activity are always recommended in overweight patients, but not always effective in reversing NASH. Promising pharmacological treatments have been demonstrated with antioxidants, insulin sensitizers, hepatoprotectants, lipid-lowering agents, and antihypertensive drugs. The similar histological features and natural histories of alcoholic steatohepatitis (ASH) and NASH suggest that common pathogenic mechanisms might be involved in these two conditions. Therapeutic strategies targeting the common mechanisms may also have promising potential. A larger randomized-controlled trial is needed to definitively determine the efficacy of pharmacological treatments for NASH.