Advances in the treatment of nonalcoholic steatohepatitis: current status and future directions

Non alcoholic steatohepatitis (NASH), a progressive subtype of nonalcoholic fatty liver disease (NAFLD), has become a major global health concern Because it can lead to cirrhosis, hepatocellular cancer, and liver failure. Obesity, type 2 diabetes, and metabolic syndrome are intimately associated with NASH, resulting in a substantial disease burden. As of 2024, there is no FDA-approved treatment for NASH despite continued research. While new treatments including GLP-1 receptor agonists, FXR agonists, and PPAR modulators are being thoroughly studied, current management concentrates on lifestyle changes and off-label pharmaceuticals like pioglitazone and vitamin E. This review examines the changing therapeutic landscape based on recent clinical trials, explains the pathophysiology of NASH, and reviews current and upcoming treatments. Understanding treatment modalities is crucial to improving results and lowering the burden of disease, which is why this review is being done.