Non-alcoholic steatohepatitis (NASH) is liver inflammation and damage caused by fat buildup, not alcohol. It affects roughly 5% of adults in the U.S. and can lead to cirrhosis or liver cancer. Until recently, no drugs were approved specifically for NASH — treatment focused on weight loss, diabetes control, and managing complications.
What's actually going on in research
Trials are testing drugs that target fat metabolism, liver inflammation, and scarring (fibrosis). GLP-1 receptor agonists like semaglutide and tirzepatide are being studied for their effects on liver fat and fibrosis. Other approaches include FGF21 analogs, thyroid hormone receptor-beta agonists, and drugs that block specific inflammatory pathways. Many trials measure whether treatments can reverse fibrosis or prevent progression to cirrhosis.
GLP-1 receptor agonists
Drugs originally developed for diabetes and weight loss are showing strong effects on liver fat in NASH. Trials are testing whether they can also reverse fibrosis, the scarring that leads to cirrhosis.
Anti-fibrotic drugs
Several drugs aim to stop or reverse liver scarring directly, rather than just reducing fat. These include drugs targeting specific collagen pathways and inflammatory signals that drive fibrosis.
Metabolic targets
Researchers are testing drugs that mimic hormones controlling fat and sugar metabolism in the liver. These include FGF21 analogs and thyroid hormone receptor-beta agonists that may reduce fat without systemic side effects.
What to know before you search
Eligibility typically requires biopsy-confirmed NASH with at least moderate fibrosis, though some trials accept imaging-based diagnosis. Prior bariatric surgery or significant alcohol use usually excludes people.
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 end to measure changes in scarring.
- Metabolic intervention trials — Testing GLP-1 drugs, insulin sensitizers, and other metabolic treatments to see if weight loss and metabolic improvement translate to liver benefit.
- Combination trials — Testing whether combining drugs that target different pathways — like fat reduction plus anti-inflammation — works better than single drugs.
- Progression studies — Following people with NASH over years to identify who progresses to cirrhosis and what biomarkers predict worsening.
- Non-invasive monitoring trials — Testing imaging and blood tests that could replace liver biopsy for diagnosing NASH and tracking treatment response.
Recently added Non-alcoholic Steatohepatitis trials
Taiwan Green Propolis for Blood Lipids and Body Fat in Patients With MASLD
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.
Dihydroartemisinin for MAFLD
Brief Summary Purpose: This is a proof-of-concept clinical trial to evaluate whether Dihydroartemisinin (DHA), a medication commonly used to treat malaria, can effectively reduce liver fat in adults with Metabolic Associated Fatty Liver Disease (MAFLD). The study will also rigorously assess the safety and tolerability of DHA in this specific patient population. Study Design: This is a single-center, open-label, single-arm study. All qualified participants will receive the investigational treatment, with each individual serving as their own baseline control to measure pre- and post-treatment changes. To minimize lifestyle-related confounding factors, all participants will receive standardized dietary and physical activity counseling at baseline and will be instructed to strictly maintain their established lifestyle routines throughout the study period. Participants: The study plans to enroll approximately 30 adult patients (ages 18 to 45 years) formally diagnosed with MAFLD. MAFLD is defined by the presence of excessive hepatic fat accumulation concurrent with specific metabolic dysfunctions, such as overweight/obesity, hypertension, elevated blood sugar, or dyslipidemia. Intervention: Participants will be administered oral Dihydroartemisinin tablets at a dose of 20 mg three times daily (TID) for a continuous duration of 12 weeks. Upon completion of the intervention, participants will enter a 12-week observational follow-up period to monitor the durability of the treatment effects and long-term safety. Main Things We Will Measure (Outcomes): Primary Outcome: Absolute change in liver fat content from baseline to the end of the 12-week treatment, quantitatively assessed by the gold-standard MRI Proton Density Fat Fraction (MRI-PDFF). Secondary Outcomes: Changes in supplementary non-invasive liver fat assessments (including Ultrasound-derived Fat Fraction \[UDFF\] and FibroScan Controlled Attenuation Parameter \[CAP\]), as well as changes in body weight, blood pressure, heart rate, and routine laboratory safety panels (e.g., comprehensive liver and kidney function tests).
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