To Dr Abdelmalek, the NIH action signifies increased focus on the significant long-term consequences of Fatty Liver disease. She discusses a Q&A at a talk she gave this summer where a physician noted that drug development is exciting but three years in the future and asked, “What can I do for my patients NOW?” She cites a recent small, early-stage study that suggested a single dose of metformin might have an impact on portal pressure and goes on to suggest that statins and beta blockers might also have a role to play in treating compensated cirrhosis patients. Louise Campbell contributes a strategy for evaluating patients taking these older drugs using FibroScan and blood-based tests. This is an innovative way to look at providing immediate benefit for patients who need it most urgently.