Non-alcoholic steatohepatitis, or NASH, is liver inflammation and damage caused by fat buildup in people who drink little or no alcohol. It affects roughly 5% of US adults and can progress to cirrhosis and liver failure. Until 2024, no medications were approved specifically for NASH, though diabetes and weight-loss drugs often help.
What's actually going on in research
Trials are testing drugs that target different pathways: GLP-1 receptor agonists like semaglutide that reduce liver fat through weight loss, thyroid hormone receptor-beta agonists that directly reduce fat and fibrosis, FGF21 analogs, and drugs that block specific inflammatory signals. Many studies now require liver biopsy to confirm NASH and measure fibrosis, the scarring that predicts who will develop cirrhosis.
GLP-1 receptor agonists
Semaglutide and tirzepatide, approved for diabetes and obesity, are being tested specifically for NASH. They produce significant weight loss, which reduces liver fat and inflammation in many people.
Thyroid hormone receptor-beta agonists
Resmetirom received FDA approval in 2024 for NASH with moderate to advanced fibrosis, the first approved NASH drug. It works directly in the liver to reduce fat and may slow fibrosis progression.
Fibrosis reversal
Several trials are testing whether drugs can actually reverse liver scarring, not just stop it from worsening. This would change outcomes for people already at risk of cirrhosis.
What to know before you search
Eligibility typically depends on biopsy-confirmed NASH, fibrosis stage, liver enzyme levels, and absence of other liver diseases or heavy alcohol use.
What types of trials are currently open
- Treatment trials — Testing drugs to reduce liver fat, inflammation, and fibrosis. Most require liver biopsy at the start and after 12-18 months to measure changes.
- Weight-loss drug trials — Testing GLP-1 drugs and other weight-loss medications to see if metabolic improvement translates to liver benefit in NASH.
- Combination trials — Testing two or more drugs together, targeting different pathways, to see if combination therapy works better than single drugs.
- Biomarker studies — Looking for blood tests or imaging that could replace liver biopsy for diagnosing NASH and tracking treatment response.
- Prevention trials — Testing whether drugs can prevent progression from simple fatty liver to NASH in people at high risk.
Recently added Non-alcoholic Steatohepatitis 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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