NASH Management in 2022

The best treatment for NASH still remains as caloric intake reduction, weight loss, exercise and no heavy alcohol consumption, but these are merely lifestyle changes. There appears to be a fibrosis regression over time following bariatric surgery in patients with severe obesity and NASH. Liver histologic improvement endpoints are likely to predict clinical benefits. NAFLD liver fibrosis is a risk factor for adverse outcomes. Improvement in the NASH fibrosis stage was associated with lower risk of liver-related outcomes. Multifactorial metabolic milieu of NASH warrants potential combination therapy targeting many pathways.