Current and emerging pharmacological therapy for non-alcoholic fatty liver disease

Table 1 Current medications that have been used for treatment of non- alcoholic fatty liver disease

Medication	Mechanism	Effect on histology	Recommended by AASLD/EASL
Pioglitazone	PPAR-γ	Improvement of steatosis, lobular inflammation and ballooning	Yes
Vitamin E	Anti-oxidant	Improvement of hepatocyte ballooning	Yes
Metformin	Amelioration of IR	No beneficial effect	No
Statins	HMG-CO A reductase inhibition	No beneficial effects	No
Ezetimibe	Inhibition of cholesterol absorption	Improvement of hepatocyte ballooning	No
Fibrates	PPAR-α	Improvement of hepatocyte ballooning	No
Pentoxifylline	Inhibition of TNF-α and anti-oxidants	Improvement of inflammation and ballooning	No
Losartan	ARB	Improvement of steatosis, lobular inflammation, ballooning and fibrosis	No
UDCA	Prevention of apoptosis/inflammation	Lacking data	No
Synbiotic and probiotics	Modulation of gut microbiota	Lacking data	No

PPAR-γ: Peroxisome proliferator-activated receptor–γ; HMG-CO A: Hydroxyl-methyl-glutaryl-coenzyme A reductase; ARB: Angiotensin receptor blockers; UDCA: Ursodeoxycholic acid; AASLD: American Association for the Study of Liver Diseases; EASL: European Association for the Study of Liver.

Table 2 Emerging medications for treatment of non- alcoholic fatty liver disease

Medication	Mechanism	Histology benefit
Obeticholic acid	Farnesoid X receptor agonist	Improvement of steatosis, lobular inflammation, ballooning and fibrosis
Aramchol	Inhibition of SCD1	Lacking data
Elafibranor	PPAR α/δ agonist	Improvement of steatosis and fibrosis
Cenicriviroc	Inhibition of CCR2/CCR5	Lacking data
Liraglutide	Glucagon-like peptide-1 agonist	Improvements in steatosis and hepatocyte ballooning

SCD1: Stearoyl CoA desaturase-1; PPAR: Peroxisome proliferator-activated receptor.