MSDC 0602, a first-in-class oral, once-daily, insulin sensitiser that acts by stimulating mitochondrial proteins, is being developed by Metabolic Solutions and Cirius Therapeutics for treatment Type 2 diabetes mellitus and Non-alcoholic steatohepatitis. MSDC-0602 prevented and reversed liver fibrosis and suppressed expression of markers of stellate cell activation in livers of mice fed a diet rich in trans-fatty acids, fructose, and cholesterol. Moreover, mice with liver-specific deletion of MPC2 were protected from development of NASH on this diet. MSDC-0602 directly reduced hepatic stellate cell activation in vitro, and MSDC-0602 treatment or hepatocyte MPC2 deletion also limited stellate cell activation indirectly by affecting secretion of exosomes from hepatocytes. Cirius Therapeutics plans the phase III trial for Type 2 diabetes mellitus and Non-alcoholic steatohepatitis in September 2019