ABSTRACT
Treatment of patients with nonalcoholic fatty liver has typically been focused on
the management of associated conditions such as obesity, diabetes mellitus, and hyperlipidemia
as well as discontinuation of potentially hepatotoxic drugs. Nonalcoholic fatty liver
associated with obesity may resolve with weight reduction, although the benefits of
weight loss have been inconsistent. Appropriate metabolic control for patients with
diabetes mellitus or hyperlipidemia is always recommended but not always effective
in reversing nonalcoholic fatty liver. Promising results of pilot studies evaluating
ursodeoxycholic acid, gemfibrozil, betaine, N-acetylcysteine, and α-tocopherol suggest that these medications may be of potential
benefit in the treatment of patients with nonalcoholic fatty liver. These medications,
however, need first to be tested in well-controlled trials with clinically relevant
end points and extended follow-up. A better understanding of the pathogenesis and
natural history of this condition will help to identify the subset of patients with
nonalcoholic fatty liver at risk of progressing to advanced liver disease and, hence,
the subgroup of patients who should derive the most benefit from medical therapy.
In this article, we review (1) the existing medical therapy for patients with nonalcoholic
fatty liver, (2) the emerging data from clinical trials evaluating potentially useful
medications, and (3) the potential therapeutic implications of recent studies on the
pathogenesis of this liver disease.
KEYWORD
Nonalcoholic fatty liver - treatment
