firsocostat + selonsertib

Firsocostat + selonsertib is an investigational oral combination therapy developed for the treatment of nonalcoholic steatohepatitis (NASH) with advanced fibrosis or cirrhosis. Firsocostat is a small molecule inhibitor of acetyl-CoA carboxylase (ACC), which reduces hepatic de novo lipogenesis and may decrease liver fat accumulation. Selonsertib is a small molecule inhibitor of apoptosis signal-regulating kinase 1 (ASK1), a protein involved in promoting inflammation, apoptosis (cell death), and fibrosis under conditions of oxidative stress. The combination aims to target multiple pathogenic pathways in NASH by reducing both hepatic fat synthesis and fibrogenesis. Clinical trials have evaluated this combination in patients with bridging fibrosis or compensated cirrhosis due to NASH; however, studies did not meet primary efficacy endpoints for significant improvement in liver fibrosis compared to placebo. Both agents are investigational and not approved for clinical use[1][2][3][4][6].