Focus on emerging drugs for the treatment of patients with non-alcoholic fatty liver disease

World J Gastroenterol. 2014 Dec 7;20(45):16841-57. doi: 10.3748/wjg.v20.i45.16841.


Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disorder in Western countries and is increasingly being recognized in developing nations. Fatty liver disease encompasses a spectrum of hepatic pathology, ranging from simple steatosis to non-alcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma and end-stage liver disease. Moreover, NAFLD is often associated with other metabolic conditions, such as diabetes mellitus type 2, dyslipidemia and visceral obesity. The most recent guidelines suggest the management and treatment of patients with NAFLD considering both the liver disease and the associated metabolic co-morbidities. Diet and physical exercise are considered the first line of treatment for patients with NAFLD, but their results on therapeutic efficacy are often contrasting. Behavior therapy is necessary most of the time to achieve a sufficient result. Pharmacological therapy includes a wide variety of classes of molecules with different therapeutic targets and, often, little evidence supporting the real efficacy. Despite the abundance of clinical trials, NAFLD therapy remains a challenge for the scientific community, and there are no licensed therapies for NAFLD. Urgently, new pharmacological approaches are needed. Here, we will focus on the challenges facing actual therapeutic strategies and the most recent investigated molecules.

Keywords: Emerging drugs; Fatty liver; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Steatosis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Obesity Agents / therapeutic use*
  • Behavior Therapy
  • Cholagogues and Choleretics / therapeutic use*
  • Comorbidity
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Hypolipidemic Agents / therapeutic use*
  • Insulin Resistance
  • Non-alcoholic Fatty Liver Disease / blood
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / drug therapy*
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / physiopathology
  • Risk Factors
  • Risk Reduction Behavior
  • Treatment Outcome
  • Weight Loss


  • Anti-Obesity Agents
  • Cholagogues and Choleretics
  • Hypoglycemic Agents
  • Hypolipidemic Agents