Advances in the treatment of nonalcoholic steatohepatitis

Table 1 Clinical research network non-alcoholic fatty liver disease activity score

Score	Steatosis (%)	Lobular inflammation	Ballooning degeneration
0	< 5	None	None
1	5 to 33	< 2 foci	Few
2	33 to 66	2 to 4 foci	Many
3	> 66	> 4 foci

Table 2 Fibrosis score in nonalcoholic steatohepatitis

Stage	Histological findings
1a	Mild pericellular fibrosis (only detected on connective tissue stain)
1b	Moderate pericellular fibrosis (detected on hematoxylin and eosin stain)
1c	Portal/periportal fibrosis without pericellular fibrosis
2	Pericellular with portal/periportal fibrosis
3	Bridging fibrosis
4	Cirrhosis

Table 3 Medical treatment of nonalcoholic steatohepatitis

Insulin sensitization
PPAR receptor agonists	Tropifexor
Glucagon like peptide 1	NGM282
Farnesoid X receptor agonists
Inhibiting lipogenesis
Acetyl coenzyme a carboxylase inhibitors
Aramchol
Modulating lipid metabolism
Polyunsaturated fatty acids
Ezetimibe
Resmetirom
Inhibiting oxidative injury
Vitamin E
Anti-fibrotics
Simtuzumab
Galectin-3 inhibitors
Anti-inflammatory and anti-apoptotic agents
Caspase inhibitors
Chemokine receptor 2 and 5 inhibitors
Manipulating the intestinal microbiome
Antibiotics, probiotics, fecal microbiota transplantation
New and emerging treatments
Apical sodium dependent bile acid transporter inhibitors
Apoptosis signal kinase-1 inhibitors
Protein kinase inhibitors
Toll-like receptor 4 antagonists

PPAR: Peroxisome proliferator activated receptors.