Research & Development

Scientific Background

Management of NAFLD/NASH

The following sets forth the general observations and guidelines for the management of NAFLD/NASH according to the American Association for the Study of Liver Diseases (AASLD), American College of Gastroenterology, and the American Gastroenterological Association

The long term outcomes of patients with NAFLD/NASH have been reported in several studies. The findings of which can be summarized as follows1:

    • Patients with NAFLD have increased overall mortality compared to matched control populations
    • The most common cause of death in patients with NAFLD and NASH is cardiovascular disease
    • Patients with NASH have an increased liver-related mortality rate
    • The loss of at least 3-5% of body weight appears necessary to improve steatosis, but a greater weight loss (up to 10%) may be needed to improve necro-inflammation
    • Metformin has no significant effect on liver histology
    • Long term safety and efficacy of pioglitazone in patients with NASH has not been established
    • Vitamin E is not recommended to treat NASH in diabetic patients, NAFLD without liver biopsy, NASH cirrhosis, or cryptogenic cirrhosis
    • UDCA is not recommended for the treatment of NAFLD or NASH
    • It is premature to consider foregut bariatric surgery as an established option to specifically treat NASH
    • Until RCTs with histological endpoints prove their efficacy, statins should not be used to specifically treat NASH

[1] Chalasani N. et al. Hepatology 2012; 55(6):2005-2023 (position paper of the AASLD – American Association for the Study of liver diseases)