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Review article: emerging anti-fibrotic therapies in the treatment of non-alcoholic steatohepatitis

Lookup NU author(s): Professor Quentin AnsteeORCiD

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Abstract

BackgroundNon-alcoholic fatty liver disease (NAFLD) can lead to non-alcoholic steatohepatitis (NASH) and cirrhosis. Fibrosis predicts worse outcomes and mortality. New treatments targeting fibrosis are being investigated to reverse disease progression.AimTo review the new pipeline therapeutic agents targeting fibrosis in NASH patients, with particular focus on clinical trials in which reversing fibrosis and portal hypertension are the primary outcomes.MethodsThe literature was searched in PubMed between January 2000 and January 2016 using search terms non-alcoholic fatty liver disease and NASH, with filters of English language'. We focused on fibrosis improvement as the key outcome. We also searched the ClinicalTrials.gov for promising agents that target fibrosis in NASH patients.ResultsSignificant advances have been made on approaches targeting fibrosis in NASH patients. Many therapeutic agents are already in development, some of which have shown promising results in preclinical and phase I studies. Novel therapies have entered phase II and III studies targeting fibrosis reversal and/or improvement in portal hypertension. Innovative studies have also started looking into combining these agents, aiming at different mechanisms to maximise therapeutic outcomes. We found five clinical trials in phase II and one in phase III focusing on fibrosis in NASH patients as key outcomes. One of the phase II trials is using combination therapy to target fibrosis.ConclusionsOngoing research studies are already investigating new pathways aimed at reversing fibrosis in NASH patients. Novel therapeutic agents are in development and are expected to offer unique options to NASH patients with advanced fibrosis.

Publication metadata

Author(s): Noureddin M, Anstee QM, Loomba R

Publication type: Review

Publication status: Published

Journal: Alimentary Pharmacology and Therapeutics

Year: 2016

Volume: 43

Issue: 11

Pages: 1109-1123

Print publication date: 01/06/2016

Online publication date: 08/04/2016

Acceptance date: 21/03/2016

ISSN (print): 0269-2813

ISSN (electronic): 1365-2036

Publisher: WILEY-BLACKWELL

URL: http://dx.doi.org/10.1111/apt.13620

DOI: 10.1111/apt.13620

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