‘A gamechanger’ Optimism follows announcement of new treatment for fatty liver

There’s renewed optimism for people with fatty liver disease, sometimes called NASH (non-alcoholic steatohepatitis) or MASH (metabolic associated steatohepatitis). The United States Food and Drug Administration recently approved the first medication, Rezdiffra, that can directly address liver damage as the person makes lifestyle changes.

“This is a gamechanger for anyone who has fatty liver disease with moderate to severe liver scarring,” says Marcie Lindstrom, APRN, a gastroenterology provider at OSF HealthCare. “This can reduce the number of complications that can develop with worsening scarring.”

The liver is an important organ. Experts even call it a miniature factory inside us. The liver detoxifies medication; releases glucose to give you energy; aids digestion and makes cholesterol, proteins and amino acids.

Obesity, diabetes, high cholesterol and excessive alcohol use can lead to fatty liver disease, which Lindstrom says impacts around one in four people worldwide. Left untreated, scarring from fatty liver disease can progress to cirrhosis, or severe scarring. Complications from cirrhosis can include enlarged blood vessels in the esophagus which can lead to life-threatening bleeding, fluid overload called ascites, liver cancer and liver failure necessitating a transplant.

Lindstrom says before Rezdiffra, people with fatty liver disease could only make those lifestyle changes to try to get better: control your blood sugar, cholesterol and weight.

“Strictly on the shoulders of the individual,” Lindstrom reiterates.

“We know that people who lose 5 to 10% of their body weight are able to make improvement with fatty liver disease. It is considered a reversible condition,” she adds.

Now, Rezdiffra is an option for people with moderate to advanced scarring.

“It works on thyroid-B receptors in the liver. We normally think of thyroid receptors in our thyroid gland [in our throat], but we do have thyroid beta receptors elsewhere. A lot of them are in the liver,” Lindstrom explains. “The medication works to release triglycerides from the liver. It improves and may even resolve fatty liver.”

It’s a once-a-day pill, Lindstrom says, and there’s no “one size fits all” for how long you need to be on it. Side effects include nausea and diarrhea, but Lindstrom says studies have shown those get better after three weeks. She also says women who are pregnant, are about to become pregnant or are breastfeeding should not take Rezdiffra. There hasn’t been enough study of the drug to see how it impacts those groups.

The bottom line: you can talk to your health care provider to see if Rezdiffra is right for you. Be sure to mention what other medicines you are taking so your provider can see how Rezdiffra might interact.

“If somebody is taking a statin for cholesterol levels,” for example, Lindstrom says. “It’s not that we want them to go off their statin. There are certain limitations to the dosage.”

Learn more about how to avoid fatty liver disease and other gastroenterology care tips on the OSF HealthCare website.