Anyone who has been paying attention to, well, life, knows that alcohol abuse utterly destroys your liver over time. It does so by depositing lots and lots of lovely fat into the liver cells, causing the liver to swell, scar, and eventually fail.
It makes a great argument for teetotaling… unfortunately, some people experiences the same effect without ever touching a drop of alcohol. It’s called Non-Alcoholic Fatty Liver Disease, or NAFLD, and to date there are no treatments for it.
But for those living with the most severe form of NAFLD, hope may be just around the corner.
Between 10 and 30% of NAFLD patients end up developing NASH, or Non-alcoholic Steatohepatitis. Of those, another 15% will end up developing cirrhosis of the liver. NASH is difficult to detect—a costly liver biopsy is the only way to diagnose NASH, and doctors report that many of their patients refuse to get one. Left undetected it can have serious consequences. Once a patient is diagnosed, treatment options are limited to low calories diets, statins, and some vitamins.
With so few options available, there is enormous room for growth. Fortunately, many pharmaceutical companies are hard at work trying to meet this need. Doctors seem to be most excited by Intercept’s Obeticholic Acid (OCA), an oral drug which is working its way through a Phase III clinical trial.
Other compounds are also winding and wending their way through the development process, and while no end point is yet in sight the developments are encouraging.
The one cautionary note is that doctors would like to see trials that place a greater emphasis on fibrosis progression and keeping costs lower.
There’s also a lot of work that needs to be done to better understand the causes of NASH—once that’s understood, disrupting it will be a slightly easier ask. Until that day, raising awareness of NASH is probably the best way to disrupt it.
