Non-alcoholic fatty liver disease (NAFLD) is the accumulation of excess fat in liver cells in people who drink little or no alcohol. It is now the most common liver disease globally, affecting roughly a quarter of adults worldwide and closely tied to obesity, type 2 diabetes, and metabolic syndrome.
What's actually going on in research
GLP-1 receptor agonists reduce liver fat substantially and are becoming the most widely tested drugs for NAFLD and its more severe form NASH, with tirzepatide (GLP-1/GIP dual agonist) showing remarkable liver fat clearance. Lifestyle intervention trials continue to demonstrate that significant weight loss — more than 10% of body weight — can reverse early liver disease. Emerging drugs targeting inflammation, fibrosis, and bile acid pathways are in trial development, though regulatory strategy for NAFLD without fibrosis is still evolving.
GLP-1 and dual agonists
Semaglutide and tirzepatide produce dramatic reductions in liver fat content measured by MRI. Trials are now testing whether this translates to clinical benefits beyond biochemical improvement.
Lifestyle intervention
Structured diet and exercise programs achieving 10%+ weight loss reliably reduce liver fat and inflammation, and trials are identifying the optimal intensity and delivery format.
Fibrosis-targeted drugs
For patients with early fibrosis alongside NAFLD, drugs targeting TGF-beta signaling and hepatic stellate cell activation are being added to metabolic therapies in combination trials.
What to know before you search
Eligibility usually requires liver fat above a threshold (often >5% on MRI), specific ALT ranges, BMI criteria, and exclusion of other liver diseases and heavy alcohol use.
What types of trials are currently open
- Lifestyle trials — Testing diet, exercise, and structured weight management programs for liver fat reduction.
- Drug trials — Testing GLP-1 agonists, metabolic agents, and novel compounds for liver fat and inflammation.
- Biomarker trials — Validating non-invasive tests (MRI-PDFF, blood biomarkers) to replace liver biopsy for diagnosis and monitoring.
- Combination therapy trials — Testing metabolic plus anti-fibrotic drug combinations in patients with NAFLD-related fibrosis.
- Pediatric NAFLD trials — Testing diet and drug interventions specifically in children and adolescents with fatty liver disease.
Recently added Non-alcoholic Fatty Liver Disease trials
Accurate Point of Care Liver Disease Diagnostics (Phase 2)
This research study is being conducted to find out more about techniques to non-invasively evaluate liver disease. This is the second phase of a project in which we are testing a new technology to evaluate the liver (LiverScope®). We will compare LiverScope® to other methods to evaluate the liver, including advanced conventional liver MR exams. MR exams are common exams used to monitor MASLD (also known as NAFLD). Conventional MR scanners use magnetic fields and radio waves to make pictures of the liver. LiverScope® is a small, portable MR-based device that uses similar, but simplified technology, and can be used on top of an exam table in an outpatient setting. LiverScope® currently is not approved for clinical use. In this second phase of the study, we took what we learned in the first phase to optimize the LiverScope® device and are now testing to see how LiverScope® measurements compare to MR after these optimizations. Study participants will be asked to complete a one-time visit which includes: * LiverScope exam * MR exam * FibroScan exam (optional) * Blood draw * Completion of study questionnaires
Tesamorelin for Reduction of Liver Fat in Adults With Fatty Liver Disease (Mock Study)
This randomized, double-blind, placebo-controlled Phase II study evaluates whether daily subcutaneous tesamorelin (a growth hormone-releasing hormone analog) reduces liver fat in adults with fatty liver disease. Participants receive tesamorelin or matching placebo for 52 weeks, with standardized lifestyle counseling in both groups. Liver fat is quantified by MRI-proton density fat fraction (MRI-PDFF). Key safety monitoring includes glucose metrics and IGF-1.
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