Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Pharmacol. Oct 28, 2020; 9(1): 1-12
Published online Oct 28, 2020. doi: 10.5497/wjp.v9.i1.1
Advances in the treatment of nonalcoholic steatohepatitis
Sandeep Mukherjee
Sandeep Mukherjee, Department of Medicine, Creighton University Medical Center, Division of Gastroenterology, Omaha, NE 68124, United States
Author contributions: Single author manuscript.
Conflict-of-interest statement: There are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Sandeep Mukherjee, FRCP (C), MBChB, Full Professor, Department of Medicine, Creighton University Medical Center, Division of Gastroenterology, Education Building, Suite 401 7710 Mercy Road, Omaha, NE 68124, United States.
Received: May 21, 2020
Peer-review started: May 21, 2020
First decision: August 22, 2020
Revised: September 19, 2020
Accepted: September 27, 2020
Article in press: September 27, 2020
Published online: October 28, 2020

Nonalcoholic steatohepatitis is a subtype of metabolic dysfunction-associated liver disease which has emerged as one of the most common causes of cirrhosis and liver transplantation in the United States and many western countries. The two leading risk factors associated with nonalcoholic steatohepatitis are obesity and insulin resistance with patients often demonstrating features of the metabolic syndrome. Histological improvement including arrest or improvement in fibrosis can occur in patients who are able to modify these risk factors when diagnosed early in the course of their disease. In addition to the development of cirrhosis and its life-threatening complications including hepatocellular carcinoma, variceal bleeding, ascites and hepatic encephalopathy, nonalcoholic steatohepatitis is also associated with coronary artery, carotid artery and peripheral vascular disease with coronary artery disease identified as the most common cause of death. Although multiple clinical trials evaluating a variety of medications targeted at different aspects in the pathogenesis and progression of nonalcoholic steatohepatitis have been completed and are still in progress, there is currently no approved treatment for this disease except for risk factor modification. This article will review the most recent and salient medical advances in the treatment of nonalcoholic steatohepatitis.

Keywords: Nonalcoholic steatohepatitis, Fibrosis, Cirrhosis, Obesity, Insulin resistance, Coronary artery disease

Core Tip: This review article discusses important advances in the medical treatment of nonalcoholic steatohepatitis. Initially considered to be a disease only affecting western countries, nonalcoholic steatohepatitis and obesity are increasing in prevalence worldwide. This review includes data from the most recent peer-reviewed journals in 2020 but does not include meeting abstracts or presentations.