The global clinical trial landscape for non-alcoholic fatty liver disease (NAFLD): current status and future prospects

Purpose: This study comprehensively analyzed the global clinical trials and depicted a landscape for non-alcoholic fatty liver disease (NAFLD) therapy. Methods: Using the Trialtrove database, we collected trial information of 2242 clinical trials. Using molecular docking analysis, we investigated the pharmacological properties of glucagon-like peptide-1 receptor (GLP-1R) agonist such as semaglutide and its binding affinity to GLP-1R protein. Based on the transcriptome data of NAFLD-related datasets, we analyzed the expression profile of GLP-1R across healthy liver and NAFLD samples. Results: Our clinical trial landscape revealed significant geographic disparities in NAFLD trials, with the US and China leading globally with 488 and 384 trials respectively. Phase IV accounted for the largest proportion (34.10%) among all trials. Among all the NAFLD-related agents, GLP-1R agonists were the most frequently used. In addition, GLP-1R was significantly and widely downregulated in NAFLD, especially in advanced stages such as non-alcoholic steatohepatitis. Conclusion: This study offers some valuable insights into the current status and future prospects of NAFLD clinical trials.