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State of the art: treatment of nonalcoholic steatohepatitis.
Curr Opin Gastroenterol 2014; 30(3):223-37CO

Abstract

PURPOSE OF REVIEW

Nonalcoholic fatty liver disease is the most common cause of chronic liver disease in Western countries, and consists of a spectrum of histopathological changes that range in severity from simple steatosis to steatohepatitis to cirrhosis. The use of pharmacological agents as adjunctive therapy to lifestyle modification is crucial, because weight loss is often difficult to achieve and maintain. The purpose of this review is to analyze the most recent literature pertaining to current therapies for nonalcoholic steatohepatitis (NASH), as there are currently no Food and Drug Administration-approved medications.

RECENT FINDINGS

Recent studies suggest that vitamin E may improve liver histology in NASH without affecting insulin resistance; however, long-term risks remain to be studied. Pioglitazone is beneficial in improving liver histology and insulin resistance, but is associated with weight gain. Emerging data suggest that pentoxifylline may also be beneficial in improving serum aminotransferase and liver histology in patients with biopsy-proven NASH.

SUMMARY

Ongoing research evaluating potential pharmacological agents for NASH is critical, because these patients are at an increased risk for cirrhosis and hepatocellular carcinoma. The current therapies being used for the treatment of NASH include the use of vitamin E and pioglitazone, in addition to dietary counseling and regular exercise.

Authors+Show Affiliations

aDivision of Gastroenterology, Department of Medicine bDivision of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, California, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

24717764

Citation

Pearlman, Michelle, and Rohit Loomba. "State of the Art: Treatment of Nonalcoholic Steatohepatitis." Current Opinion in Gastroenterology, vol. 30, no. 3, 2014, pp. 223-37.
Pearlman M, Loomba R. State of the art: treatment of nonalcoholic steatohepatitis. Curr Opin Gastroenterol. 2014;30(3):223-37.
Pearlman, M., & Loomba, R. (2014). State of the art: treatment of nonalcoholic steatohepatitis. Current Opinion in Gastroenterology, 30(3), pp. 223-37. doi:10.1097/MOG.0000000000000060.
Pearlman M, Loomba R. State of the Art: Treatment of Nonalcoholic Steatohepatitis. Curr Opin Gastroenterol. 2014;30(3):223-37. PubMed PMID: 24717764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - State of the art: treatment of nonalcoholic steatohepatitis. AU - Pearlman,Michelle, AU - Loomba,Rohit, PY - 2014/4/11/entrez PY - 2014/4/11/pubmed PY - 2014/12/30/medline SP - 223 EP - 37 JF - Current opinion in gastroenterology JO - Curr. Opin. Gastroenterol. VL - 30 IS - 3 N2 - PURPOSE OF REVIEW: Nonalcoholic fatty liver disease is the most common cause of chronic liver disease in Western countries, and consists of a spectrum of histopathological changes that range in severity from simple steatosis to steatohepatitis to cirrhosis. The use of pharmacological agents as adjunctive therapy to lifestyle modification is crucial, because weight loss is often difficult to achieve and maintain. The purpose of this review is to analyze the most recent literature pertaining to current therapies for nonalcoholic steatohepatitis (NASH), as there are currently no Food and Drug Administration-approved medications. RECENT FINDINGS: Recent studies suggest that vitamin E may improve liver histology in NASH without affecting insulin resistance; however, long-term risks remain to be studied. Pioglitazone is beneficial in improving liver histology and insulin resistance, but is associated with weight gain. Emerging data suggest that pentoxifylline may also be beneficial in improving serum aminotransferase and liver histology in patients with biopsy-proven NASH. SUMMARY: Ongoing research evaluating potential pharmacological agents for NASH is critical, because these patients are at an increased risk for cirrhosis and hepatocellular carcinoma. The current therapies being used for the treatment of NASH include the use of vitamin E and pioglitazone, in addition to dietary counseling and regular exercise. SN - 1531-7056 UR - https://www.unboundmedicine.com/medline/citation/24717764/State_of_the_art:_treatment_of_nonalcoholic_steatohepatitis_ L2 - http://dx.doi.org/10.1097/MOG.0000000000000060 DB - PRIME DP - Unbound Medicine ER -