Nonalcoholic fatty liver disease (NAFLD) affects an estimated one billion people in the world. NAFLD is a spectrum of disease ranging from steatosis to steatohepatitis with variable outcomes that include cirrhosis and hepatocellular carcinoma. Lifestyle adjustment may be sufficient to manage steatosis, but success is difficult to achieve and sustain. In addition, patients with advanced forms of NAFLD or faster rates of progression need more efficient treatment. There is still no approved pharmacotherapy for NAFLD and current options have been limited to the secondary use of drugs developed for the treatment of obesity or diabetes and to hepatoprotective agents for the effect of which the strength of evidence is variable. However, recent advances in pharmaceutical research may soon change the landscape with several promising drug candidates in the pipeline designed to target specific molecular mechanisms implicated in the pathogenesis of NAFLD
