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Animal studies using galectin-3 protein inhibitors have demonstrated a decrease in fibrosis which has subsequently been replicated in phase I human studies.78 An initial phase IIa trial of GR-MD-02 given over 16 weeks assessed change in fibrosis by MRI in 30 patients with biopsy proven NASH and stage 3 fibrosis.79 Although this study did not achieve its primary endpoint, this agent is undergoing subsequent evaluation in a longer term (one year), randomised, placebo-controlled, phase IIb trial in patients with compensated NASH cirrhosis and portal hypertension (HVPG 6 mmHg)