Non-alcoholic steatohepatitis (NASH) is liver inflammation caused by fat buildup in people who drink little or no alcohol, and it is rapidly becoming a leading cause of cirrhosis, liver failure, and liver cancer. Until recently no approved treatments existed, but that has changed.
What's actually going on in research
Resmetirom, a thyroid hormone receptor-beta agonist, became the first approved treatment for NASH with liver fibrosis, and it reduces both fat and inflammation in the liver. Multiple other drugs — including GLP-1 agonists, FGF21 analogs, and ACC inhibitors — are in late trials and several combinations appear additive. The field is moving rapidly from single-agent to combination therapy trials as researchers recognize that NASH has multiple driving pathways.
Resmetirom (THR-beta agonist)
Resmetirom activates thyroid hormone receptors specifically in the liver to reduce fat accumulation and inflammation. It is now approved for NASH with fibrosis and is becoming the backbone of combination trials.
GLP-1 agonists in NASH
Semaglutide and tirzepatide reduce liver fat, inflammation, and body weight dramatically and are in Phase 3 trials specifically measuring fibrosis resolution as the primary endpoint.
Combination therapy
Trials are testing two or three drugs targeting different NASH pathways simultaneously — such as a GLP-1 agonist plus a FGF21 analog — to achieve more complete liver fibrosis regression.
What to know before you search
Eligibility requires liver biopsy confirmation of NASH with fibrosis stage (typically F2–F3), often includes BMI and liver enzyme thresholds, and excludes other liver diseases.
What types of trials are currently open
- Drug trials — Testing new medications targeting liver fat, inflammation, and fibrosis in NASH.
- Combination therapy trials — Evaluating two- and three-drug combinations targeting different NASH pathways simultaneously.
- Cirrhosis trials — Testing whether NASH drugs can benefit patients who have already progressed to early cirrhosis.
- Metabolic syndrome trials — Combining NASH therapy with weight loss and cardiovascular risk reduction strategies.
- Biomarker trials — Validating non-invasive liver tests (MRI, blood biomarkers) to replace repeated liver biopsies in trials.
Recently added Non-alcoholic Steatohepatitis trials
Hepatoprotective Effects of Reishi Mushroom- (Ganoderma Lucidum) Among Metabolic Dysfunction-associated Fatty Liver Disease Patients
This 12-week RCT investigates the hepatoprotective and immunomodulatory effects of Ganoderma lucidum combined with a probiotic-rich diet in adults with MAFLD, assessing liver enzymes, lipid profile, inflammation, gut microbiota, and oxidative stress. Findings are expected to show dose-dependent improvements in hepatic fat, insulin resistance, and inflammatory markers, potentially reducing reliance on pharmacotherapy in
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
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