New evidence indicates that niacin (not as a vitamin, but at pharmacologic doses) may treat nonalcoholic fatty liver disease. In vivo and in vitro data demonstrate that niacin reverses hepatic steatosis, inflammation (steatohepatitis), and prevents fibrosis. Steatosis significantly decreased 47% from baseline in a small clinical trial associated with reductions in liver enzymes and inflammatory marker C-Reactive Protein. Mechanism is oxidative stress reduction, diacylglycerol acyltransferase-2 (DGAT-2) inhibition. Niacin offers the opportunity for combination therapy with other drugs in development for enhanced synergistic efficacy. Advantages include immediate availability for clinical trials, treats atherogenic dyslipidemia and atherosclerotic cardiovascular disease (ASCVD) commonly seen in NAFLD patients. Randomized clinical trials are urgently needed for a potential cost-saving treatment for this serious disease with no approved treatment at present.
Niacin, Non-alcoholic Fatty Liver Disease, Non-alcoholic Steatohepatitis, Fibrosis, Oxidative Stress, Diacylglycerol acyltransferase-2, Niacin Extended-Release