Commentary
As explained in the review by M. L. Petroni et al. (“Alma Mater” University, Bologna, Italy), several drugs are under investigation according to the agreed targets of reduced NASH activity without worsening of fibrosis or improving fibrosis without worsening of NASH.
Anti-inflammatory, anti-fibrotic agents and metabolism modulators have been tested in randomised controlled trials; a few failed, and others have produced marginally positive results, but only a few are being tested in extension studies.
In light of current knowledge of the various functions of PPARs, it can be speculated that activation of PPARα, PPARδ and PPARγ by lanifibranor, a pan-PPAR agonist, may be an effective therapeutic approach to prevent the development and progression of NASH through a combination of metabolic, anti-inflammatory and antifibrotic effects, thereby addressing a large spectrum of parameters involved in the disease along its continuum.
