Recently the AASLD Postgraduate Course discussed emerging treatments for nonalcoholic fatty liver disease/nonalchoholic steatohepatitis. From AASLD News: Emerging Treatments for NASH 

Key point:

• Quentin Anstee: “It is important to remember that our patients with fatty liver disease will most likely die of cardiovascular disease, not liver disease.”

Four principles in treating nonalcoholic fatty liver disease (NAFLD) to address both cardiovascular and liver risks.

• Target obesity with lifestyle changes and, possibly, bariatric surgery.
• Target metabolic syndrome to reduce cardiovascular disease risk using medications with additional liver-directed benefits.
• Target liver disease to prevent progression of steatohepatitis to fibrosis and cirrhosis.
• Minimize downstream complications such as hepatocellular carcinoma.

More than 60 phase 3 trials are underway –Primary Therapeutic Targets:

• PPAR signaling (insulin signaling, glucose and lipid metabolism, energy homeostasis, inflammation)
• FXR signaling (insulin sensitivity, glucogenesis, lipogenesis)
• ASK1 signaling (apoptosis)
• CCR2/CCR5 signaling (inflammation and fibrogenesis).