Non-alcoholic fatty liver disease affects roughly one in four adults worldwide. It ranges from simple fat buildup in the liver to inflammation and scarring that can progress to cirrhosis. No medications are FDA-approved specifically for NAFLD yet, though weight loss through diet and exercise remains the primary treatment.
What's actually going on in research
Trials are testing drugs that target different aspects of liver fat and inflammation — GLP-1 receptor agonists like semaglutide that reduce weight and liver fat, thyroid hormone receptor agonists that boost fat burning in liver cells, FGF21 analogs, and drugs that block specific inflammatory pathways. Researchers are also working to refine how liver damage is measured without biopsy.
GLP-1 receptor agonists
Semaglutide and tirzepatide, already approved for diabetes and weight loss, are showing strong effects on liver fat and inflammation in NAFLD trials. Large studies are testing whether they can prevent progression to cirrhosis.
Thyroid hormone receptor agonists
These drugs activate thyroid receptors specifically in the liver, increasing fat breakdown without affecting the heart or other organs. Resmetirom recently received FDA approval for NASH with fibrosis, the first approved drug for this condition.
FXR and FGF21 targeting
Drugs that activate the FXR receptor or mimic FGF21 hormone aim to reduce liver fat and inflammation through different metabolic pathways. Several are in mid-stage and late-stage testing.
What to know before you search
Eligibility typically depends on liver fat percentage on imaging, degree of fibrosis on biopsy or elastography, and absence of other liver diseases or significant alcohol use.
What types of trials are currently open
- Treatment trials — Testing drugs that reduce liver fat and inflammation, often measured by MRI or biopsy after 12 to 18 months of treatment.
- Fibrosis regression trials — Studies focused on whether drugs can reverse scarring in people who already have significant liver fibrosis.
- Weight loss trials — Testing whether GLP-1 drugs and other weight-loss medications improve liver health in people with NAFLD and obesity.
- Combination trials — Studies testing two or more drugs together to see if attacking different pathways works better than single drugs.
- Biomarker studies — Following people with NAFLD to identify blood tests or imaging that can replace liver biopsy for tracking disease progression.
Recently added Non-alcoholic Fatty Liver Disease trials
Take a new medication combined with existing drugs for fatty liver disease
Non-alcoholic fatty liver disease is a chronic, serious, life-threatening, inflammatory liver disease characterized by increased liver fat content, inflammation, and progressive fibrosis. The overall prevalence of non-alcoholic fatty liver disease is rapidly rising world-wide. ECC4703 is a potential new treatment for non-alcoholic fatty liver disease. The purpose of this research is to investigate the safety, tolerability and pharmacokinetics of sulfasalazine and pitavastatin when combined with ECC4703.
Take a natural bee product to help reduce liver fat and improve metabolism
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver condition linked to excess body fat, high blood lipids, and other metabolic problems. Taiwan green propolis is a natural health product collected by bees from plants, which has shown potential benefits for blood lipids and body fat in laboratory and animal studies. However, its effects in people with MASLD have not been well established in clinical trials. This study is a double-blind, randomized, placebo-controlled trial enrolling up to 60 adults with MASLD at Dalin Tzu Chi Hospital in Taiwan. Eligible participants are randomly assigned in a 1:1 ratio to receive either Taiwan green propolis capsules or matching placebo capsules for 12 weeks. Participants take 2 capsules before breakfast and 2 capsules before dinner each day (4 capsules per day total). Neither participants nor the research team know which capsules are being taken until the study ends. The study measures changes in blood lipids (triglycerides, total cholesterol, LDL-C, and HDL-C), body fat percentage, body weight, waist circumference, liver enzymes, blood sugar levels, inflammatory markers, and health-related quality of life. Liver fat and scarring are assessed by abdominal ultrasound before and after the intervention. Gut microbiota samples are also collected. Assessments are conducted at baseline, at 4 weeks, 8 weeks, 12 weeks (end of intervention), and at follow-up visits 2 weeks and 12 weeks after the intervention ends. The goal of this study is to provide scientific evidence on whether Taiwan green propolis can safely and effectively improve blood lipids, body fat, and metabolic health in people with MASLD, and to explore the relationship between physiological improvements and health behavior changes.
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