Sapporo Medical Journal

Abstract : Nonalcoholic fatty liver disease (NAFLD) is becoming a leading cause of chronic liver injury and its end-stage may require liver transplantation. The NAFLD affects approximately one-fourth of the population and is common in both developed and developing countries. The changes caused by COVID-19 pandemic can show an upward trend in hepatic disease incidence & sequels. Weight reduction via life-style and bariatric interventions are considered lines of NAFLD treatment. The complex pathogenesis of NAFLD gives a chance for several novel agents in treatment. The drugs can target any of the pathways including energy balance & metabolism and/or cellular stress & steatoheptitis, as well as apoptotic & fibrotic changes. Several pharmacological agents including Aramchol Semaglutide, Obeticholic Acid, Dapagliflozin, Pemafibrate, Saroglitazar, Emricasan, and Cenicriviroc are in advanced phases of clinical trials for NAFLD. The present work presents a summarized the marketed medications like Metformin, Pioglitazone, α-Tocopherol, Omega-3 fatty acids, and Ursodeoxycholic acid that are employed in the treatment of NAFLD with emphasis on their pharmacokinetics (bioavailability, distribution, biotransformation, and elimination), precautions during therapy, and adverse effects. Presently, the clinical outcomes of the pharmacological agents remain poor and future work is required to get established effective novel medications to optimize the therapeutic regimens for NAFLD.