Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 05 / 13 / 2021



Drugs for Non-alcoholic Steatohepatitis (NASH): Quest for the Holy Grail

Mithun Sharma1, Madhumita Premkumar2, Anand V Kulkarni*,1, Pramod Kumar1, D Nageshwar Reddy3 and Nagaraja Padaki Rao1

1  Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India
2  Department of Hepatology, PGIMER, Chandigarh, India
3  Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
*Correspondence to: Dr. Anand V Kulkarni, Department of Hepatology and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India. Tel: +91-40-42444222, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2021;9(1):40-50 DOI: 10.14218/JCTH.2020.00055
Received: June 16, 2020 Accepted: November 12, 2020 Published online: December 9, 2020


Nonalcoholic fatty liver disease (NAFLD) is a global epidemic that is likely to become the most common cause of chronic liver disease in the next decade, worldwide. Though numerous drugs have been evaluated in clinical trials, most of them have returned inconclusive results and shown poorly-tolerated adverse effects. None of the drugs have been approved by the Food and Drug Administration for treating biopsy-proven non-alcoholic steatohepatitis (NASH). Vitamin E and pioglitazone have been extensively used in treatment of biopsy-proven nondiabetic NASH patients. Although some amelioration of inflammation has been seen, these drugs did not improve the fibrosis component of NASH. Therefore, dietary modification and weight reduction have remained the cornerstone of treatment of NASH; moreover, they have shown to improve histological activity as well as fibrosis. The search for an ideal drug or ‘Holy Grail’ within this landscape of possible agents continues, as weight reduction is achieved only in less than 10% of patients. In this current review, we summarize the drugs for NASH which are under investigation, and we provide a critical analysis of their up-to-date results and outcomes.


Fatty liver, NAFLD, NASH, Obeticholic acid, Saroglitazar

Journal of Clinical and Translational Hepatology 2021 vol. 9, 40-50  [ Html  ] [ PDF Full-text ]

© The Author(s) 2021. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.


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