Z Gastroenterol 2019; 57(04): 508-517
DOI: 10.1055/a-0784-8827
© Georg Thieme Verlag KG Stuttgart · New York

Nonalcoholic steatohepatitis (NASH) – current treatment recommendations and future developments

Nichtalkoholische Steatohepatitis (NASH) – aktuelle Behandlungsempfehlungen und zukünftige Entwicklungen
Elke Roeb
1   Department of Gastroenterology, Justus-Liebig-University & University-Hospital Giessen, Giessen
Andreas Geier
2   Division of Hepatology, University-Hospital Würzburg, Würzburg, Germany
› Author Affiliations
Further Information

Publication History

17 July 2018

05 November 2018

Publication Date:
09 April 2019 (online)


Nonalcoholic fatty liver disease (NAFLD) includes nonalcoholic fatty liver (NAFL), nonalcoholic steato hepatitis (NASH) and NASH cirrhosis. NAFLD is the leading cause of liver diseases in the Western world (Central Europe, United States). The NAFLD incidence increases because of increasing type 2 diabetes and obesity. This article reviews the scientific findings of epidemiology, diagnostic, and therapeutic management of NAFLD. Lifestyle modifications (low-caloric Mediterranean diet and exercise training) to reduce weight are a major factor in the treatment of NAFLD.

Pharmacological therapies may be useful in patients with NASH and fibrosis as well as nonresponders to lifestyle modifications. Currently, however, no pharmacological substances are approved for the indication NASH.


Die nichtalkoholische Fettlebererkrankung (NAFLD) umfasst die nichtalkoholische Fettleber (NAFL), die nichtalkoholische Steatohepatitis (NASH) und die NASH-Zirrhose. NAFLD ist die Hauptursache für Lebererkrankungen in der westlichen Welt (Mitteleuropa, USA). Die NAFLD-Inzidenz steigt aufgrund der Zunahme von Typ-2-Diabetes und Fettleibigkeit. Diese Übersicht fasst den aktuellen Wissensstand bezüglich Epidemiologie, Diagnose und klinischem Management von NAFLD sowie zukünftige Therapieansätze anhand aktueller Leitlinien und Studien zusammen. Life-Style-Modifikationen (kalorienarme mediterrane Diät und Ausdauertraining) zur Erzielung eines Gewichtsverlustes sind das Hauptziel im Rahmen aktueller therapeutischer Empfehlungen zu NAFLD. Eine pharmakologische Therapie könnte bei Patienten mit NASH und Fibrose sowie Non-Respondern der Life-Style-Modifikationen hilfreich sein. Aktuell sind allerdings noch keine pharmakologischen Substanzen für die Indikation NASH zugelassen.

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