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Novel Pharmacotherapy Options for NASH.

Vlad Ratziu1

  • 1Institute for Cardiometabolism and Nutrition (ICAN), Hôpital Pitié Salpêtrière, Service d'hépatogastroentérologie, Université Pierre et Marie Curie, 47-83 Bd de l'Hôpital, 75013, Paris, France. vlad.ratziu@upmc.fr.

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Summary

Diet and lifestyle changes are insufficient for nonalcoholic steatohepatitis (NASH). New pharmacotherapies targeting specific liver injury pathways show promise, with ongoing trials to confirm efficacy and safety.

Keywords:
AramcholCenicrivirocElafibranorLiraglutideNonalcoholic steatohepatitisObeticholic acid

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Area of Science:

  • Hepatology
  • Pharmacology
  • Gastroenterology

Background:

  • Nonalcoholic steatohepatitis (NASH) treatment often relies on diet and lifestyle, which have limited efficacy and sustainability.
  • A growing need exists for specific pharmacotherapies to address NASH progression.
  • Current NASH drug development is shifting from repurposed drugs to targeted molecules.

Purpose of the Study:

  • To review the current landscape of pharmacotherapy development for nonalcoholic steatohepatitis (NASH).
  • To highlight promising drug candidates and their targeted pathways.
  • To discuss the evolving pipeline of NASH treatments.

Main Methods:

  • Review of current clinical trials and drug development for NASH.
  • Analysis of key drug candidates, including obeticholic acid and elafibranor.
  • Examination of emerging therapies targeting specific molecular pathways.

Main Results:

  • Obeticholic acid and elafibranor show encouraging results in improving hepatic histology and NASH resolution.
  • Obeticholic acid demonstrated improvement in liver fibrosis, while elafibranor improved glycemic and lipid profiles.
  • Several other drug candidates are in various phases of clinical trials, targeting diverse pathways.

Conclusions:

  • Pharmacotherapy is increasingly recognized as essential for NASH management.
  • Targeted therapies like obeticholic acid and elafibranor represent a significant advancement.
  • The dynamic NASH pipeline suggests a promising future for effective treatments.