Published online Aug 27, 2023. doi: 10.4254/wjh.v15.i8.1001
Peer-review started: April 30, 2023
First decision: June 7, 2023
Revised: June 18, 2023
Accepted: August 7, 2023
Article in press: August 7, 2023
Published online: August 27, 2023
Processing time: 113 Days and 16.6 Hours
Non-alcoholic fatty liver disease (NAFLD) has become a global health issue with significant medical costs. The lack of a Federal Drug Administration (FDA)-approved medication for the treatment of NAFLD has prompted the investigation of several potential therapeutic classes. It is valuable to have a compilation of the data available on their efficacy.
Due to the absence of an approved medication by the FDA for the treatment of NAFLD, several therapeutic classes have been investigated in clinical trials. It is important to understand the mechanisms and statistical significance of the agents being investigated, as NAFLD is extremely prevalent.
To assess the efficacy of cyclophilin inhibitors, fibroblast growth factor 21 analogs (FGF21), and dual and pan peroxisome proliferator-activated receptor (PPAR) agonists as possible therapeutic classes for treating NAFLD.
We searched PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science using keywords including cyclophilin inhibitor, FGF agonist, pan-PPAR agonists, dual-PPAR agonist, NAFLD, non-alcoholic steatohepatitis, and fatty liver. Articles with a National Institutes of Health Quality Assessment score of five or higher were included. Each article was screened by two independent researchers evaluating relevance and quality. Pertinent data were extracted in a sprea
We identified 29 studies that met the necessary criteria and were included in this review. These records included 12 human studies and 17 animal studies. Specifically, there were four studies on cyclophilin inhibitors, four on FGF analogs, 11 on pan-PPAR agonists, and ten on dual-PPAR agonists. All classes were found to be efficacious for the treatment of NAFLD with statistical significance (P < 0.05).
We found that cyclophilin inhibitors, fibroblast growth factor 21 analogs, and dual and pan PPAR agonists are not only statistically efficacious for the treatment of NAFLD but also generally well tolerated. We recommend more extensive human clinical research to further delineate therapy's efficacy, dosage, and duration.
It is to be expected that additional human clinical trials of the therapeutic classes assessed in this review, as well as additional novel agents, will be conducted in the near future. An FDA-approved agent for the treatment of NAFLD is of utmost importance.