Nonalcoholic fatty liver disease including cirrhosis

• 1959Hydrochlorothiazide approved (FDA)
• 1960Spironolactone approved (FDA)
• 1964Triamterene approved (FDA)
• 1966Furosemide approved (FDA)
• 1985Trientine approved (FDA)
• 1985Ribavirin approved (FDA)
• 1987Ursodiol approved (FDA)
• 2016Obeticholic acid approved (FDA)
• 2024Seladelpar approved (FDA)
• 2024Resmetirom approved (FDA)

Trials started per year, stacked by phase (darker = later phase). Source: ClinicalTrials.gov via Clin2, which tracks studies recruiting in recent years — early years undercount.

Treatability is disease-modifying only for a defined subset: an approved drug, resmetirom, can slow fat and inflammation in adults with moderate fibrosis, but there is no reversal or cure. Most people rely on lifestyle change, and cirrhosis complications are managed symptomatically. The disease has grown steadily alongside the obesity epidemic, and deaths are likely rising. The most important milestone is the approval of resmetirom, the first drug shown to shift the disease itself. Research momentum is real: 564 trials are now active, including 44 phase-3 studies, so more disease-specific treatments may emerge in years ahead.

Can liver damage from this disease be reversed?

In early stages, losing fat and weight can reduce liver fat, but once fibrosis exists it does not disappear. Resmetirom can slow further scarring in a subset, but no drug has yet shown reversal of established cirrhosis.

Is a cure close?

Not close. Still, 564 trials are currently active, with 44 in phase-3, testing a range of anti-fibrotic and metabolic drugs. That work may broaden the treatable stages, but a true cure is not on the immediate horizon.

Why are cases increasing?

The disease closely tracks obesity, diabetes, and metabolic syndrome. As those have become more common, the liver condition has risen in parallel, and it is expected to keep rising until the underlying metabolic trends change.

What does it mean to have a 'disease-modifying' drug?

It means the drug acts on the disease process itself—reducing fat and inflammation related to fibrosis—rather than only treating symptoms. It is approved only for adults with moderate fibrosis, and access also depends on stage and insurance.

Will everyone eventually need cirrhosis care?

No. Most people with fatty liver never progress to cirrhosis, and lifestyle change can halt or slow the course. But those who do develop advanced disease may ultimately require liver transplantation for survival.