Overview:
Nonalcoholic steatohepatitis (NASH) is also known as ‘fatty liver’ a disorder that develops in patients who are not alcoholic; mainly causes liver damage that is diagnostically indistinguishable from alcoholic hepatitis. The key risk factors observed in patients suffering from NASH are obesity, glucose intolerance, and dyslipidemia. The challenges that are faced in the diagnosis of the disease are mainly due to poor understanding of pathogenesis linked to insulin resistance especially in obesity or metabolic syndrome. Market experts suggest that most of the patients are asymptomatic and laboratory findings related with NASH mainly include elevations in aminotransferase levels. However, in diagnosis of NASH biopsy pays key role in diagnosis. According to American Liver Foundation, NASH is the third leading cause of liver transplant in the U.S.; database suggests more than 12% of the general population has NASH and approximately 2.7% have advanced liver fibrosis due to the disease. NASH comprises treatment of obesity, insulin sensitizing agents, lipid-lowering agents, antioxidants, and hepatoprotective therapy. In NASH treatment weight reduction has been widely studied in adults and has shown improvement not only the biochemical results but also the histology.
According to Cleveland Clinic, reduction of dietary carbohydrates, in particular dietary fructose, is the most beneficial and has been found to improve the lipid profile in overweight patients. Several drugs have been studied, including sibutramine, a serotonin reuptake inhibitor, and orlistat, which reduce fat absorption. Both of these have been shown to improve liver enzyme levels and sonographic signs of fatty liver. A meta-analysis of rimonabant, a cannabinoid-1-antagonist, showed that it is associated with increased adverse events and currently it cannot be recommended for NAFLD. In case of insulin –sensitizing agents, peroxisome proliferator-activated receptor gamma (PPARg) agonists (thioglitazones) have projected improvement in insulin resistance, by acting as surrogate marker of fatty liver, and promoting redistribution of triglycerides from the liver and muscle into proliferating adipocytes. According to a recently published review article that was conducted by an expert panel from the “Chilean Gastroenterological Society” and the “Chilean Hepatology Association” suggested that, pioglitazone along with vitamin E is a proven pharmacological choice for patients with biopsy-proven NASH, however evidence on its long-term safety and efficacy is lacking. Moreover, the guidelines of the American Association for the Study of Liver Diseases indicate pioglitazone as a possible therapeutic drug for the treatment of NASH.
North America was observed as the largest market for NASH treatment followed by Europe. In North America, rising prevalence of obesity, and increasing incidence of diabetes are the key factors assisting the NASH treatment market. According to Cleveland Clinic, The prevalence of overweight persons in the US has risen to more than 65%, and obesity is now present in more than 30% of the adult US population. The prevalence is increased in men, older individuals (those aged 40-70 years), and those with components of the metabolic syndrome especially diabetes and abdominal obesity. The prevalence of childhood obesity and non-alcoholic fatty liver disease (NAFLD) is at similar levels. NAFLD has been observed in all ethnic groups with the highest prevalence seen in Hispanics compared with Caucasians and African Americans Asia Pacific was anticipated to grow at a fastest CAGR during the forecast period 2016 to 2022.
The global non-alcoholic steatohepatitis (NASH) treatment market is segmented on the following bases:
1. Type of Treatment
a. Weight Loss Treatment
i. Sibutramine
ii. Orlistat
b. Insulin-Sensitizing Agents
i. Metformin
ii. Thiazolidinedione
iii. Rosiglitazone
iv. Pioglitazone
c. Lipid-Lowering Drugs
i. Gemfibrozil
d. Antioxidants
i. Vitamine E
ii. N-acetylcysteine
iii. Betaine
iv. Pentoxifylline
e. Other Agents
i. Angiotensin-converting enzyme inhibitors
ii. Angiotensin-receptor blockers
iii. Monounsaturated fatty acids
iv. Polyunsaturated fatty acids
2. Pipeline Analysis (Phase I, Phase II and Phase III Clinical Trials)
a. Projected sales of Phase III Drugs estimated till 2023 (US$ Mn)
b. Tabular Representation of Phase II and I Drugs
3. Geography
a. North America
i. US
ii. Canada
b. Europe
i. UK
ii. Germany
iii. Rest of Europe
c. Asia-Pacific
i. Japan
ii. China
iii. Rest of APAC
d. Latin America
e. Middle East and Africa
Key Players Identified for Non-Alcoholic Steatohepatitis (NASH) Treatment Market Include but are Not Limited to:
The key players in the market are Astazeneca Plc, Galmed Pharmaceuticals Ltd., GENFIT SA, Gilead Science, Novo Nordisk, Immuron Ltd., Intercepts Pharmaceuticals, Enzo Biochem, Inc., Conatus Pharmaceuticals, Raptor Pharmaceutical Corp., Tobira Therapeutics, Inc., and others
This report offers:
