Prof. Sven Francque, Chair of the PanNASH initiative reviews the current management options in NASH and the many molecules in development. It sheds light on the rationale for PPAR agonists as a promising and very valuable therapeutic option with systemic potential, for what happens in the liver and outside of the liver.

An understanding of the pathogenesis and natural course of NAFL and NASH is essential to develop new treatments and design clinical trials. These conditions are not static, but dynamic, and may progress or regress at variable rates in different individuals or even in the same individual at different times.

Prof Jean-François Dufour, Switzerland sheds lights on this important question.

The PanNASH initiative is led by an international, multidisciplinary expert committee

• Medical experts in areas related to NASH such as hepatology, diabetes, and cardiology
• Scientific experts focused on promoting a better understanding of the pathophysiological mechanisms involved in NASH

It is estimated that 25% of the global adult population is potentially affected by non-alcoholic fatty liver disease (NAFLD), with the highest prevalence in the Middle East and South America and the lowest in Africa.

Liver biopsy studies suggest that fibrosis progresses at a rate of approximately one stage per decade, suggesting that stage 2 fibrosis will progress to cirrhosis within 20 years.

NAFLD and NASH are substantial public health and economic burden.

Type 2 diabetes mellitus (T2DM) is present in about 23% of NAFLD patients and about 44% of NASH patients.(7) Moreover, NAFLD oftentimes precedes T2DM.