Treatment of the Fatty Liver Disease

Currently in Spain there is no approved drug available for non-alcoholic fatty liver disease, but several clinical trials are underway evaluating different potential treatments. A drug called Resmetirom, approved in the US in 2024, has shown promising results in reducing the fibrosis and inflammation associated with fatty liver in patients during the initial stages of fibrosis. It is currently being evaluated in patients with cirrhosis. It may reach our country in the coming years, and could then be offered to patients with advanced fibrosis. New active drugs that slow down the disease are expected to appear in the coming years.

There are also new drugs against diabetes and obesity that can promote great weight loss, but they have not been seen to improve fibrosis in the liver, which is the main factor that marks the progression and prognosis of this disease.

Despite the lack of drugs, different studies have shown that weight loss of at least 5% allows liver fat to be reduced and that a weight loss of more than 10% promotes reversal of the disease by reducing fibrosis (scar tissue).

Since the disease is closely associated with changes in metabolic syndrome, it has also been seen that optimal control of diabetes, hypertension and cholesterol slows down the disease and promotes its improvement.

The best treatment currently available is a change in lifestyle: following a Mediterranean diet, avoiding sugary drinks and saturated fats and exercising 2 or 3 times a week.

Bariatric surgery and some endoscopic techniques that allow relevant weight loss are also promising options to reduce the progression of metabolic fatty liver disease in a certain group of patients, especially those with significant obesity or other diseases, such as diabetes, high cholesterol and sleep apnoea syndrome. However, endoscopic techniques require further studies.