摘要
We earlier reviewed how obesity has assumed an endemic/pandemic proportions that has resulted in escalating incidence and prevalence of associated escalating worldwide incidence of Metabolic Syndrome(MetS)with non alcoholic fatty liver disease(NAFLD),that is correlated with enhanced morbidity.Later we tried to detail how probiotics,L-Carnitine(LC),Nicotinamide Ribose(NR)Combination,along with Apical Sodium Dependent Bile Acids Transporter(ASBT)or Volixibat and Silybin,Vitamin D,Allyl Isothiocyanate(AITC),might aid in treating and understand the etiopathogenesis of NAFLD.The prevalence of NAFLD all over the world is approximately 25%,with that of non alcoholic steatohepapititis(NASH),varying from 1.5%=6.45%.Particularly NASH,specifically the ones associated with fibrosis possess a greater chance of generation of side effects that include progression to cirrhosis as well as liver-associated mortality.Despite an improvement was observed with vitamin E,Pioglitazone.liraglutide in histological appearance in liver randomized controlled clinical trials(RCT),at present no drugs exists that have received FDI approval for NASH.The aim of this review was to update the newer drugs getting evaluated,undergoing phase 2-3 trials.Currently there are Obeticholic acid,elafibranor,cenicriviroc,resmetriom,in addition to aramchol,that are the five agents that are getting analysed in big,histology dependent phase 3 trials.Hopefully within another 2-4 years,newer,efficacious drugs will be available for the therapy of NASH.Besides that a lot of phase 2 trials are continuing for different drugs.Further depending on outcomes of phase 2-3 trials,combination treatments are getting evaluated.For future therapeutic approaches would be made up of variations in NASH phenotypes,besides personalized approaches based on various NASH phenotypes in addition to response of every single patient.Further recently there were reports of utilization of curcumin with nonselective beta blocker for regression from cirrhosis(reviewed by us).Hopefully once there are approved therapies for NAFLD/NASH,we can work in that direction.
