Cardiovascular disease and progressive cirrhosis cause mortality to a roughly equal degree in patients with NASH. PPAR α, / and transcription factors regulate many metabolic-immune and fibrosis pathways that in aggregate address the broad disease biology of NASH. Lanifibranor, a novel and balanced pan-PPAR agonist currently evaluated in a phase 3 study, has demonstrated efficacy on histological NASH resolution and improvement of fibrosis in patients with non-cirrhotic NASH in the phase 2 NATIVE study. Lanifibranor also improved a broad panel of markers of cardiometabolic health, incl. markers of lipid and carbohydrate metabolism, insulin resistance, systemic inflammation, blood pressure and hepatic steatosis quantified by CAP Fibroscan.
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