Current and future therapeutic regimens for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Autor: Zobair M. Younossi, Keith D. Lindor, Scott L. Friedman, Mary E. Rinella, Stephen H. Caldwell, Giulio Marchesini, Philippe Mathurin, Naga Chalasani, Rohit Loomba, Elisabetta Bugianesi, Brent A. Neuschwander-Tetri, Jacob George, Stephen A. Harrison, Lawrence Serfaty, Manal F. Abdelmalek, Zachary Goodman, Kathleen E. Corey, Arun J. Sanyal, Francesco Negro, Michael Charlton, Vlad Ratziu, Joel E. Lavine, Kris V. Kowdley, Quentin M. Anstee
Přispěvatelé: Younossi, Zobair M., Loomba, Rohit, Rinella, Mary E., Bugianesi, Elisabetta, Marchesini, Giulio, Neuschwander-Tetri, Brent A., Serfaty, Lawrence, Negro, Francesco, Caldwell, Stephen H., Ratziu, Vlad, Corey, Kathleen E., Friedman, Scott L., Abdelmalek, Manal F., Harrison, Stephen A., Sanyal, Arun J., Lavine, Joel E., Mathurin, Philippe, Charlton, Michael R., Chalasani, Naga P., Anstee, Quentin M., Kowdley, Kris V., George, Jacob, Goodman, Zachary D., Lindor, Keith
Rok vydání: 2018
Předmět:
0301 basic medicine
Oncology
Cirrhosis
medicine.medical_treatment
Medical Biochemistry and Metabolomics
Liver transplantation
Oral and gastrointestinal
Hepatitis
surgery
0302 clinical medicine
Non-alcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease
Clinical Trials as Topic
exercise
Liver Disease
anti-fibrotic
3. Good health
clinical trial endpoint
Hepatocellular carcinoma
030211 gastroenterology & hepatology
glitazone
medicine.medical_specialty
Clinical Trials and Supportive Activities
Chronic Liver Disease and Cirrhosis
Clinical Sciences
Immunology
Context (language use)
digestive system
03 medical and health sciences
Rare Diseases
Clinical Research
Internal medicine
Weight Loss
medicine
Humans
Obesity
Exercise
Gastroenterology & Hepatology
Hepatology
business.industry
Prevention
nutritional and metabolic diseases
medicine.disease
digestive system diseases
Liver Transplantation
Clinical trial
Good Health and Well Being
030104 developmental biology
weight lo
Steatohepatitis
Digestive Diseases
business
Zdroj: Hepatology (Baltimore, Md.), vol 68, iss 1
ISSN: 1527-3350
0270-9139
Popis: Nonalcoholic fatty liver disease (NAFLD) and its progressive form non-alcoholic steatohepatitis (NASH), are rapidly becoming among the top causes of cirrhosis, hepatocellular carcinoma, and indications for liver transplantation. Other than lifestyle modification through diet and exercise, there are currently no other approved treatments for NASH/NAFLD. Although weight loss can be effective, it is difficult to achieve and sustain. In contrast, bariatric surgery can improve metabolic conditions associated with NAFLD, and has been shown to improve liver histology. To have approved regimens for the treatment of NASH/NAFLD, several issues must be addressed. First, all stakeholders must agree on the most appropriate clinical trial endpoints for NASH. Currently, resolution of NASH (without worsening fibrosis) or reduction of fibrosis stage (without worsening NASH) are the accepted endpoints by the regulatory authorities. It is important to recognize the prognostic implication of histologic features of NASH. In this context, although histologic NASH has been associated with advanced fibrosis, it is not an independent predictor of long-term mortality. In contrast, there are significant data to suggest that fibrosis stage is the only robust and independent predictor of liver-related mortality. In addition to the primary endpoints, several important secondary endpoints, including noninvasive biomarkers, long-term outcomes, and patient-reported outcomes must be considered. In 2018, a few phase 3 clinical trials for the treatment of NASH have been initiated. Additionally, a number of phase 2a and 2b clinical trials targeting different pathogenic pathways in NASH are in the pipeline of emerging therapies. CONCLUSION: Over the next 5 years, some of these regimens are expected to provide potential new treatment options for patients with NASH/NAFLD. (Hepatology 2018;68:361-371).
Databáze: OpenAIRE
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