Nonalcoholic Steatohepatitis (NASH)

What is NASH?

Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD), in which fat buildup in the liver causes inflammation and damage. NASH is usually asymptomatic in its early stages and, if left untreated, can lead to the formation of scar tissue, a process called fibrosis, which can progress to liver cirrhosis and increase the risk for liver cancer.

Who is at risk for developing NASH?

The top risk factor for developing NAFLD and NASH is being overweight or obese, which is defined by having a Body Mass Index (BMI) over 25 or over 30, respectively. Other risk factors include type 2 diabetes, metabolic syndrome, insulin resistance, high cholesterol (hypercholesterolemia), and high blood pressure (hypertension).

NASH is becoming more and more common as the obesity rate in the US continues to rise. By 2020, it is expected to surpass hepatitis C as the leading indication for liver transplantation.

How do I know if I have NASH?

Since NASH is usually asymptomatic in its early stages, many people have it for several years before being diagnosed. In advanced cases of NASH, symptoms of severe liver damage may appear, such as yellowing of the skin and eyes (jaundice), confusion (hepatic encephalopathy), fluid buildup in the abdomen (ascites), and the formation of large varicose veins in the lower esophagus (esophageal varices).

If your doctor suspects that you may have NAFLD or NASH, he/she will order a series of exams, which could include blood tests, ultrasound, MRI and liver biopsy. While NAFLD can often be diagnosed noninvasively with imaging technology, a liver biopsy is the only proven way to determine if it has progressed to NASH. Noninvasively diagnosing and evaluating NASH is an ongoing area of research here at UC Davis.

What are the treatment options for NASH?

The first line of treatment for fatty liver disease is lifestyle modification, including weight loss, diabetes management, and exercise. The liver is a resilient organ that has shown a remarkable ability to heal itself once the underlying reason for disease is removed.

Currently, there are no FDA-approved drugs to treat NASH, but there are several drugs currently being tested in clinical trials. UC Davis offers several experimental treatment opportunities with these new drugs being developed.

Are there any NASH clinical trials currently recruiting at UC Davis?

Yes! Click here to see our active clinical trials for NASH.

Do I qualify for a NASH clinical trial?

Each clinical trial we offer is a little bit different and the eligibility criteria for each study can vary considerably. You can view eligibility criteria for each study on the clinicaltrials.gov website link above, or contact our Clinical Trials Unit to see if we have a clinical trial that you might qualify for. If you qualify for more than one, we can help you decide which trial is the best for your individual situation. If you don’t qualify, we may have an observational study opportunity available, since the eligibility criteria are typically less restrictive.

Are there other resources available?

The following list contains links to websites with helpful information for patients with NASH: