Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis

Table 5 Recommendations about pharmacological treatment of non-alcoholic fatty liver disease

	EASL	NICE	ASIA-PACIFIC	AISF	AASLD
Metformin	Insufficient evidence	Not beneficial	Not beneficial	Not mentioned	Not beneficial
Vitamin E	Insufficient evidence	Consider use regardless of diabetes	Not beneficial	Insufficient evidence	Consider use in non-diabetic, biopsy-proven NASH
PPAR-gamma agonists	Consider use in selected diabetic patients	Consider pioglitazone in adults regardless of diabetes	Insufficient evidence in Asian	Insufficient evidence, potentially useful	Pioglitazone indicated in biopsy-proven NASH (regardless of diabetes)
PUFA	Not beneficial	Insufficient evidence	Not beneficial	Not mentioned	Not beneficial
Pentoxifylline	Insufficient evidence	Not mentioned	Not beneficial	Not mentioned	Not mentioned
GLP-1 analogues	Insufficient evidence, potentially useful	Insufficient evidence	Insufficient evidence in Asian patients	Insufficient evidence, potentially useful	Insufficient evidence
UDCA	Not beneficial	Not beneficial	Not mentioned	Not mentioned	Not beneficial
Obetycolic acid	Scarce evidence	Not mentioned	waiting for ongoing RCT results	Waiting for ongoing RCT results	Insufficient evidence
Silymarin	Not mentioned	Not mentioned	insufficient evidence, potentially useful	Not mentioned	Not mentioned
Statins	Safe but not beneficial	Safe but not beneficial	Safe but not beneficial	Safe but not beneficial	Safe but not beneficial

EASL: European Association for the Study of the Liver; NICE: National Institute for Health and Care Excellence; AISF: Italian Association for the Study of the Liver; AASLD: American Association for the Study of Liver Diseases; PPAR: Peroxisome proliferator-activated receptors; PUFA: Poly-unsaturated fatty acids; GLP-1: Glucagon-like peptide-1.