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
Trial to Evaluate ALN-CIDEB in Adults With Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
This study will test a Regeneron study drug called ALN-CIDEB to find out whether it may help treat a liver disease called metabolic dysfunction-associated steatohepatitis (MASH). MASH is more advanced stage of a broader liver disease, MASLD. MASLD is a liver condition caused by too much fat building up in the liver. This can lead to liver scarring and inflammation and can reduce the liver's ability to keep the body healthy. Cell death-inducing DFFA-like effector B (CIDEB) is a protein made by liver cells that helps the liver to store fat. The study is looking at: * What side effects ALN-CIDEB might cause * How well ALN-CIDEB works to change liver fat, liver injury, and liver scarring * How ALN-CIDEB could affect the body and the liver, which can help researchers understand why ALN-CIDEB works better for some people than others
Try a supervised exercise program to improve heart health
metabolic syndrome and fatty liver is common in adolescents with celiac diseases. exercise may control these cardiovascular risk factors
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