Review of galectin-3 inhibitors in the treatment of nonalcoholic steatohepatitis

Introduction Galectin-3 (Gal-3) is a beta-galactoside binding protein associated with many disease pathologies, including chronic inflammation and fibrogenesis. It has been implicated in the disease severity of NASH, although its precise role is unknown. Inhibition of Gal-3 has shown to improve and prevent fibrosis progression and has now reached phase III clinical trial in NASH patients. Areas covered This discusses the role of Gal-3 in NASH. It brings together the current findings of Gal-3 in NASH and hepatic fibrosis by analyzing recent data from animal model studies and clinical trials. Expert opinion Gal-3 inhibitors, in particular, Belapectin (GR-MD-02), have shown promising results for NASH with advanced fibrosis. In a phase 2 trial, Belapectin did not meet the primary endpoint. However, a sub-analysis of Belapectin among a separate group of patients without esophageal varices showed 2 mg/kg of GR-MD-02 reduced HVPG and the development of new varices. A subsequent study is under way, aiming to replicate the positive findings in phase 2 and demonstrate greater efficacy. If Belapectin is shown to be effective, it will be coupled with other drugs that target steatohepatitis to maximize efficacy and disease reversal.

Automated summary

Gal-3 is a beta-galactoside binding protein associated with disease pathologies such as chronic inflammation and fibrogenesis, with ongoing studies investigating its role in NASH. Gal-3 inhibitors, particularly Belapectin, have shown promising results in NASH patients with advanced fibrosis, with further research aiming to replicate positive findings and demonstrate greater efficacy. If proven effective, Belapectin may be used in combination with other drugs targeting steatohepatitis for maximum efficacy and disease reversal.