Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease

Title:Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease

Volume: 16 Issue: 3

Author(s): Konstantinos Imprialos, Konstantinos Stavropoulos, Sofia Bouloukou, Georgios Kerpiniotis, Asterios Karagiannis and Michael Doumas*

Affiliation:

• Second Propaedeutic Department of Medicine, Aristotle University, Thessaloniki,Greece

Keywords: Non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, pioglitazone, vitamin E, drugs, alcohol.

Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) affects a large proportion of the general population. The disease ranges from simple steatosis, to non-alcoholic steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma. Several drugs are used in daily clinical practice to manage the disease. However, data on their efficacy in liver histology are not consistent.

Aim: We discuss current treatment options for NAFLD and NASH and preliminary results from novel drugs under investigation.

Results: Among various drugs assessed for the management of NAFLD and NASH, only pioglitazone and vitamin E have provided consistent benefits on liver histology, and are recommended by the European and American guidelines. Statins were shown to produce clinically meaningful results in patients with NAFLD or NASH. Other drugs such as metformin and polyunsaturated fatty acids that are being used in clinical practice off-label have provided benefits on terms of hepatic biochemical and diabetesrelated markers; data on liver histology with these drugs are scarce and from small studies. Several new approaches to reduce inflammation, steatosis or fibrosis have shown promising results in experimental models of NAFLD or NASH lesions and are being evaluated in humans.

Conclusion: Pioglitazone and vitamin E are the only drugs providing consistent benefits and are currently recommended for NASH. Various pathogenetic pathways are being targeted to reduce steatosis, inflammation and fibrosis and early data on several novel drugs are very promising. On-going human trials will unveil their true impact.

Cite this article as:

Imprialos Konstantinos, Stavropoulos Konstantinos , Bouloukou Sofia , Kerpiniotis Georgios , Karagiannis Asterios and Doumas Michael*, Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease, Current Vascular Pharmacology 2018; 16 (3) . https://dx.doi.org/10.2174/1570161115666170621083744