The effect of ezetimibe on NAFLD

NAFLD has become the most common liver disorder in countries, where obesity, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome are common. The strong association between these conditions and the risk of cardiovascular disease make treatment crucial. Possible interventions for NAFLD target excess body weight, insulin resistance, inflammation, oxidative stress or intestinal lipid absorption. Administration of combination therapy with a statin plus ezetimibe, associated with lifestyle changes, may represent an effective strategy because of the strong reduction in low-density lipoprotein cholesterol levels. Combination therapy is often more effective, especially when complementary mechanisms of action are involved. Ezetimibe is effective and well tolerated in combination with a number of lipid lowering therapies, including statins, orlistat, and insulin-sensitizing agents. There is strong evidence from preclinical models to supporting the use of ezetimibe in this setting. Larger controlled trials are needed to confirm its effectiveness in patients with NAFLD, to establish the most efficacious combinations and to determine whether treatment can reverse fibrosis.