Non-alcoholic fatty liver disease ("NAFLD") is a reversible condition wherein large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis.
NASH is a more advanced state of NAFLD and can progress to a cirrhotic liver and eventually hepatocellular carcinoma or liver cancer. Twenty to thirty percent of the U.S. population is estimated to suffer from NAFLD and fifteen to twenty percent of this group progress to NASH, which is a substantially large population that lacks effective therapy. NAFLD/NASH is becoming more common due to its strong correlation with obesity and metabolic syndrome, including components of metabolic syndrome such as diabetes, cardiovascular disease and high blood pressure. In men, especially with comorbidities associated with NAFLD/NASH, testosterone deficiency has been associated with an increased accumulation of visceral adipose tissue and insulin resistance, which factors contributing to NAFLD/NASH.
Preclinical and clinical studies in the literature have shown the prevalence of testosterone deficiency across the NAFLD/NASH histological spectrum wherein low testosterone was independently associated with NAFLD/NASH with an inverse relationship between testosterone and NAFLD/NASH.
Post hoc analyses of existing clinical trial in subjects with comorbidities typically associated with NASH indicate that oral testosterone therapy significantly and consistently reduces elevated levels of key serum biomarkers (liver function enzymes and serum triglyceride) generally associated with NAFLD/NASH.
NAFLD prevalence in general population is estimated to be 20-30% in the Western world (Masarone et al, Rev Recent Clin Trials, 2014)
By 2020, prevalence of NAFLD cirrhosis is set to overtake hepatitis B and hepatitis C related cirrhosis (Starley et al, Hepatol, 2010)
The NASH market could peak at $30-40 billion by 2025 (Deutsche Bank industry report, “NASH – the next big global epidemic in 10 years?”, 2014)