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Nonalcoholic fatty liver disease: new treatments.
Curr Opin Gastroenterol 2015; 31(3):175-83CO

Abstract

PURPOSE OF REVIEW

Nonalcoholic fatty liver disease is the most common cause of liver dysfunction in the western world because of its close association with obesity, insulin resistance and dyslipidaemia. Nonalcoholic steatohepatitis (NASH) is a particular health concern due to the increased morbidity and mortality associated with progressive disease. At present, without specific targeted pharmacological therapies, the mainstay of therapy remains weight loss through dietary modification and lifestyle change; thus, the purpose of this review is to summarize the recent evidence for current and emerging therapies in NASH.

RECENT FINDINGS

Some existing medications, including pioglitazones and angiotensin receptor antagonists, may be repurposed to help treat this condition. Vitamin E may improve histology in NASH, but safety issues limit its use. Recently, a number of novel agents specifically targeting nonalcoholic fatty liver disease pathogenesis have entered clinical trials, including the farnesoid X receptor agonist obeticholic acid, which has shown significant histological improvements in steatohepatitis and fibrosis.

SUMMARY

Diet/lifestyle modification remains the mainstay of treatment. For patients with NASH and advanced fibrosis, current liver-directed pharmacotherapy with vitamin E and pioglitazone offer some benefits; obeticholic acid appears promising and is currently being tested. Comorbidities must be diagnosed and treated; cardiovascular disease remains a primary cause of death in these patients.

Authors+Show Affiliations

Liver Research Group, Institute of Cellular Medicine, The Medical School, Newcastle University, Newcastle-Upon-Tyne, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

25774446

Citation

Hardy, Timothy, et al. "Nonalcoholic Fatty Liver Disease: New Treatments." Current Opinion in Gastroenterology, vol. 31, no. 3, 2015, pp. 175-83.
Hardy T, Anstee QM, Day CP. Nonalcoholic fatty liver disease: new treatments. Curr Opin Gastroenterol. 2015;31(3):175-83.
Hardy, T., Anstee, Q. M., & Day, C. P. (2015). Nonalcoholic fatty liver disease: new treatments. Current Opinion in Gastroenterology, 31(3), pp. 175-83. doi:10.1097/MOG.0000000000000175.
Hardy T, Anstee QM, Day CP. Nonalcoholic Fatty Liver Disease: New Treatments. Curr Opin Gastroenterol. 2015;31(3):175-83. PubMed PMID: 25774446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonalcoholic fatty liver disease: new treatments. AU - Hardy,Timothy, AU - Anstee,Quentin M, AU - Day,Christopher P, PY - 2015/3/17/entrez PY - 2015/3/17/pubmed PY - 2016/2/5/medline SP - 175 EP - 83 JF - Current opinion in gastroenterology JO - Curr. Opin. Gastroenterol. VL - 31 IS - 3 N2 - PURPOSE OF REVIEW: Nonalcoholic fatty liver disease is the most common cause of liver dysfunction in the western world because of its close association with obesity, insulin resistance and dyslipidaemia. Nonalcoholic steatohepatitis (NASH) is a particular health concern due to the increased morbidity and mortality associated with progressive disease. At present, without specific targeted pharmacological therapies, the mainstay of therapy remains weight loss through dietary modification and lifestyle change; thus, the purpose of this review is to summarize the recent evidence for current and emerging therapies in NASH. RECENT FINDINGS: Some existing medications, including pioglitazones and angiotensin receptor antagonists, may be repurposed to help treat this condition. Vitamin E may improve histology in NASH, but safety issues limit its use. Recently, a number of novel agents specifically targeting nonalcoholic fatty liver disease pathogenesis have entered clinical trials, including the farnesoid X receptor agonist obeticholic acid, which has shown significant histological improvements in steatohepatitis and fibrosis. SUMMARY: Diet/lifestyle modification remains the mainstay of treatment. For patients with NASH and advanced fibrosis, current liver-directed pharmacotherapy with vitamin E and pioglitazone offer some benefits; obeticholic acid appears promising and is currently being tested. Comorbidities must be diagnosed and treated; cardiovascular disease remains a primary cause of death in these patients. SN - 1531-7056 UR - https://www.unboundmedicine.com/medline/citation/25774446/Nonalcoholic_fatty_liver_disease:_new_treatments_ L2 - http://dx.doi.org/10.1097/MOG.0000000000000175 DB - PRIME DP - Unbound Medicine ER -