Characterization of polypharmacy in patients with NAFLD.

Challenge

Polypharmacy in NAFLD is a recognized problem but the overall magnitude of medication burden—including the number of medications, their mechanism-of-action distribution, and how burden scales with disease severity across the full NAFLD spectrum including pediatric patients—had not been systematically described.

Solution

The TARGET-NASH registry was analyzed to characterize the distribution of medication counts, frequency of specific drug classes, and variation in polypharmacy by disease severity across adult and pediatric NAFLD patients, with descriptive statistics and comparative testing.

Impact

Providing the foundational characterization of polypharmacy burden in NAFLD—including the median of 11 medications in cirrhosis vs. 5 in NAFL—equips drug developers with the baseline medication landscape needed to anticipate DDI risk and design appropriate concomitant medication policies for NAFLD trials.