Therapeutic Trials in Nonalcoholic Steatohepatitis: Insulin Sensitizers and Related Methodological Issues

Insulin sensitizers are attractive candidate therapies for nonalcoholic steatohepatitis mainly because of the strong association between this disease and insulin resistance This review provides a critical overview of the mechanisms of action, clinical trial results, and safety issues of metformin and glitazones in nonalcoholic steatohepatitis It also highlights methodological challenges for trial design and proposes endpoints for future proof of principle, registrational, and postmarketing trials (HEPATOLOGY 2010,52 2206-2215)