1Division of Endocrinology and Metabolism, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
3Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
4Division of Endocrinology and Metabolism, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
5Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Body weight | Liver enzymes | Hepatic steatosis | NAS | Fibrosis | RCT/MA or SR | |
---|---|---|---|---|---|---|
Lifestyle modification | ↓ | ↓a/↔b | ↓ | ↓a | ↓a | RCT/MA or SR |
Anti-diabetic agents | ||||||
Metformin | ↓ | ↓ | ↓ | ↓/↔a,b | NA | RCT/MA or SR |
Thiazolidinediones | ||||||
Pioglitazone | ↑ | ↓ | ↓ | ↓a | ↓a,c | RCT/MA or SR |
Lobeglitazone | ↑ | ↓ | ↓ | NA | NA | X |
GLP-1 RA | ||||||
Liraglutide | ↓ | ↓ | ↓a | ↔a | ↓a | RCT |
Exenatide | ↓ | ↓ | ↓ | NA | NA | X |
Lixisenatide | ↓ | ↓ | NA | NA | NA | X |
DPP-4 inhibitors | ||||||
Sitagliptin | ↔ | ↓/↔b | ↓/↔b | NA | NA | X |
Vildagliptin | ↔ | ↓ | ↓ | NA | NA | X |
SGLT2 inhibitors | ||||||
Dapagliflozin | ↓ | ↓ | ↓ | NA | ↔c | RCT |
Canagliflozin | ↓ | ↓ | ↓ | NA | ↓/↔b,c | X |
Empagliflozin | ↓ | ↓ | ↓ | NA | NA | X |
Ipragliflozin | ↓ | ↓ | ↓ | NA | ↓c | RCT |
Luseogliflozin | ↓ | ↓ | ↓ | NA | ↔c | X |
Non–anti-diabetic agents | ||||||
Vitamin E | ↔ | ↓a | ↓a | ↓a | NA | X |
Pentoxifylline | NA | ↓a | ↓/↔a,b | ↓/↔a,b | ↔a | X |
Obeticholic acid | ↓a | ↓a | NA | ↓a | ↓a | RCT |
Elafibranor | NA | ↓a | NA | ↓a | ↓a | RCT |
Cenicriviroc | ↔a | ↔a | NA | ↔a | ↓a | RCT |
Carnitine | ↔ | ↓ | ↓ | NA | NA | RCT |
Saroglitazar | ↔ | ↓ | NA | NA | NA | X |
Orlistat | ↓ | ↓a | ↓a | ↓a | ↔b,c | RCT/MA or SR |
Bariatric surgery | ↓ | ↓a | ↓a | ↓a | ↓a | RCT/MA or SR |
Drug | Mechanism of action | Latest phase of development |
---|---|---|
Dulaglutide | GLP-1 RA | Phase IV recruiting |
Tofogliflozin | SGLT2 inhibitor | Phase IV recruiting |
Lanifibranor (IVA337) | PPAR α/γ/δ triple activators | Phase II recruiting |
BKFB8488A | Antibody to fibroblast growth factor-1 complex | Phase I recruiting |
SAR425899 | Dual GLP-1 receptor/glucagon receptor agonist | Phase II anticipated |
HTD1801 | Lipid modulator | Phase II recruiting |
Foralumab | Oral anti-CD3 antibody | Phase II anticipated |
NAS, nonalcoholic fatty liver disease activity score; RCT, randomized controlled trial; MA, meta-analysis; SR, systematic review; NA, no data available; X, none; GLP-1 RA, glucagon-like peptide-1 receptor agonist; DPP-4, dipeptidyl peptidase-4; SGLT2, sodium-glucose co-transporter 2. aIt is a weak level of evidence because not all study participants have been diabetes, bMixed results, cEvaluated by non-invasive hepatic fibrosis markers (nonalcoholic fatty liver disease fibrosis score, fibrosis-4 [FIB-4] index).
GLP-1 RA, glucagon-like peptide-1 receptor agonist; SGLT2, sodium-glucose co-transporter 2; PPAR, peroxisome proliferator-activated receptor.