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Multi-drug approaches to NASH: what’s in the development pipeline?

Multi-drug approaches to NASH: what’s in the development pipeline?
Multi-drug approaches to NASH: what’s in the development pipeline?
Introduction: The pandemic of obesity over the last two decades has triggered a rise in the prevalence of nonalcoholic fatty liver disease (NAFLD). NAFLD is associated with liver-related and cardiovascular complications. Despite this, the first licensed drug for NAFLD is yet to be approved. Given the scale of the problem and unmet needs, there is a myriad of agents in the development pipeline.

Areas covered: We discuss promising agents in early phase clinical trials and categorize these agents based on their action on steatosis, steatohepatitis, and fibrosis. Furthermore, given the multisystemic nature of NAFLD, we consider the effects of these agents on the liver, their cardiometabolic effects, and the potential future strategies of combination therapies.

Expert opinion: The paradigm for the ideal drug is the targeting of both steatohepatitis and fibrosis and the amelioration of cardiometabolic risk factors. New drugs that confer benefit in nonalcoholic steatohepatitis (NASH) must also be tested for their effects on type 2 diabetes mellitus and cardiovascular disease. The treatment of NASH will become analogous to the treatment of hypertension; it is very likely that multiple classes of drugs targeting different mechanistic pathways will be necessary because no single agent is likely to control all aspects of this complex liver disease.
NAFLD, NASH, diabetes, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, obesity
1354-3784
143-150
Johnston, Michael P.
e1c8ffe6-1f98-4ae6-b5d5-c60880883a96
Patel, Janisha
e44aaa1e-7bdd-4b67-9fdf-a21767f00bee
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Johnston, Michael P.
e1c8ffe6-1f98-4ae6-b5d5-c60880883a96
Patel, Janisha
e44aaa1e-7bdd-4b67-9fdf-a21767f00bee
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c

Johnston, Michael P., Patel, Janisha and Byrne, Christopher (2020) Multi-drug approaches to NASH: what’s in the development pipeline? Expert Opinion on Investigational Drugs, 29 (2), 143-150. (doi:10.1080/13543784.2020.1668926).

Record type: Review

Abstract

Introduction: The pandemic of obesity over the last two decades has triggered a rise in the prevalence of nonalcoholic fatty liver disease (NAFLD). NAFLD is associated with liver-related and cardiovascular complications. Despite this, the first licensed drug for NAFLD is yet to be approved. Given the scale of the problem and unmet needs, there is a myriad of agents in the development pipeline.

Areas covered: We discuss promising agents in early phase clinical trials and categorize these agents based on their action on steatosis, steatohepatitis, and fibrosis. Furthermore, given the multisystemic nature of NAFLD, we consider the effects of these agents on the liver, their cardiometabolic effects, and the potential future strategies of combination therapies.

Expert opinion: The paradigm for the ideal drug is the targeting of both steatohepatitis and fibrosis and the amelioration of cardiometabolic risk factors. New drugs that confer benefit in nonalcoholic steatohepatitis (NASH) must also be tested for their effects on type 2 diabetes mellitus and cardiovascular disease. The treatment of NASH will become analogous to the treatment of hypertension; it is very likely that multiple classes of drugs targeting different mechanistic pathways will be necessary because no single agent is likely to control all aspects of this complex liver disease.

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Manuscript_Multi-drug approaches to NASH_R2 - Accepted Manuscript
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Accepted/In Press date: 8 September 2019
e-pub ahead of print date: 23 September 2019
Published date: 1 February 2020
Additional Information: Funding Information: CD Byrne is supported in part by the Southampton NIHR Biomedical Research Centre, UK. Publisher Copyright: © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
Keywords: NAFLD, NASH, diabetes, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, obesity

Identifiers

Local EPrints ID: 434047
URI: http://eprints.soton.ac.uk/id/eprint/434047
ISSN: 1354-3784
PURE UUID: 66f9eaef-27c2-47e3-8535-5a142aaf85cf
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 11 Sep 2019 16:30
Last modified: 17 Mar 2024 02:49

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Author: Michael P. Johnston
Author: Janisha Patel

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