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Review
. 2022 Jun 16;71(10):2123-2134.
doi: 10.1136/gutjnl-2021-326874. Online ahead of print.

Current therapies and new developments in NASH

Jean-François Dufour  1 , Quentin M Anstee  2 , Elisabetta Bugianesi  3 , Stephen Harrison  4   5 , Rohit Loomba  6 , Valerie Paradis  7 , Herbert Tilg  8 , Vincent Wai-Sun Wong  9 , Shira Zelber-Sagi  10   11
Affiliations
Review

Current therapies and new developments in NASH

Jean-François Dufour et al. Gut. .

Abstract

Non-alcoholic steatohepatitis is becoming the most important aetiology for advanced liver disease. There has been important progress in the field in recent years and the complexity of the pathophysiology of NASH is better understood. Multiple non-invasive circulating and imaging biomarkers have been tested. The importance of lifestyle has been recognised and several drugs are being tested in clinical trials. This review addresses the challenges that healthcare professionals face in the management of NASH patients.

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Conflict of interest statement

Competing interests: J-FD: Advisory committees : Abbvie, Alientis, Allergan, Axcella, Bayer, Bristol-Myers Squibb, Eisai, Enyo Pharma, Falk, Genfit, Gilead Sciences, HepaRegeniX, Intercept, Ipsen, Inventiva, Madrigal, Merck, Novartis, Pfizer, Roche, Trilliome DTx. Speaking and teaching : Bayer, Intercept, Genfit. Royalties : BMJ Journals, Springer, UpToDate. Quentin Anstee: Research Grant Funding: Abbvie, Allergan/Tobira, AstraZeneca, GlaxoSmithKline, GlympseBio, Novartis Pharma AG, Pfizer. Active Research Collaborations (including research supported through the EU IMI2 LITMUS Consortium*). Abbvie, Antaros Medical*, Allergan/Tobira, AstraZeneca, Boehringer Ingelheim International*, Ellegaard Gottingen Minipigs AS*, Eli Lilly & Company*, Exalenz Bioscience*, Genfit SA*, GlaxoSmithKline, HistoIndex, Intercept Pharma Europe*, iXscient*, Nordic Bioscience*, Novartis Pharma AG*, Novo Nordisk A/S*, One Way Liver Genomics SL*, Perspectum Diagnostics*, Pfizer.*, Sanofi-Aventis Deutschland*, SomaLogic*, Takeda Pharmaceuticals International SA*. Consultancy (undertaken on behalf of Newcastle University): Abbott Laboratories, Acuitas Medical, Allergan/Tobira, E3Bio, EcoR1, Eli Lilly & Company, Galmed, Genfit SA, Gilead, Grunthal, HistoIndex, Imperial Innovations, Intercept Pharma Europe, Inventiva, IQVIA, Janssen, Madrigal, MedImmune, NewGene, NGMBio, Novartis, Novo Nordisk A/S, Pfizer, Poxel, Raptor Pharma, Servier, Viking. Speaker: Abbott Laboratories, Allergan/Tobira, BMS, Clinical Care Options, Falk, Genfit SA, Gilead, Kenes. Elisabetta Bugianesi: Consultant: Gilead Sciences, Intercept, BMS, NovoNordisk, Pfeizer, Inventiva, Genfit, Lilly, MSD. Stephen Harrison: Scientific advisor or consultant for Akero, Alentis, Altimmune, Arrowhead, Axcella, Cirius, Cymabay, Echosens, Fibronostics, Forest Labs, Galectin, Genfit, Gilead,Hepagene, Hepion, HistoIndex, Intercept, Madrigal, Medpace, Metacrine, NGM Bio, Northsea, Novo Nordisk, PathAI, Poxel, Sagimet, Terns, Viking, 89 Bio. Stock options: Akero, Cirius, Galectin, Genfit, Hepion, HistoIndex, PathAI, Metacrine, NGM Bio, Northsea. Grant/Research support: Akero, Axcella, BMS, Cirius, CiVi Biopharma, Conatus, Cymabay, Enyo, Galectin, Genentech, Genfit, Gilead, Hepion, Hightide, Intercept, Madrigal, Metacrine, NGM Bio, Novartis, Novo Nordisk, Northsea, Pfizer, Sagimet, Viking. Rohit Loomba: Research supported by PI, R01DK106419, NIDDK, NIH; PI, R01DK121378, NIDDK, NIH; PI, R01 DK124318, NIDDK, NIH; PI, U01, NASH-CRN, NIDDK, NIH; PI, U01, AA029019, NIAAA, NIH; Project PI, P01HL147835, NHLBI; Investigator Initiated Research Grant, Astrazeneca; Investigator initiated Research Grant, Gilead Inc. Investigator initiated Research grant, Janssen Inc. Valérie Paradis: Consultant: Inventiva; Teaching: Novartis. Vincent Wong: Consultancy: 3V-BIO, AbbVie, Allergan, Boehringer Ingelheim, Echosens, Gilead Sciences, Inventiva, Merck, Novartis, Novo Nordisk, Pfizer, ProSciento, Sagimet Biosciences, TARGET PharmaSolutions, Terns. Lectures: Abbott, AbbVie, Echosens, Gilead Sciences, Novo Nordisk. Research grants: Gilead Sciences Stock: Co-founder of Illuminatio Medical Technology.

Figures

Figure 1
Figure 1
Histology of NASH illustrating steatosis, lobular inflammation, portal fibrosis and centrolobular fibrosis. NASH, non-alcoholic steatohepatitis.
Figure 2
Figure 2
Proposed primary care pathway versus standard care for patients with NAFLD, adapted from Srivastava et al. EFL, enhanced liver fibrosis; FIB-4, fibrosis-4 index; NAFLD, non-alcoholic fatty liver disease.
Figure 3
Figure 3
Lifestyle recommendations for patients with NAFLD. BMI, body mass index; NAFLD, non-alcoholic fatty liver disease.
Figure 4
Figure 4
Potential therapeutic targets for NASH, updated and adapted from Konerman et al.
See this image and copyright information in PMC

References

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