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Nonalcoholic steatohepatitis: emerging targeted therapies to optimize treatment options.
Drug Des Devel Ther 2015; 9:4835-45DD

Abstract

Diet and lifestyle changes have led to worldwide increases in the prevalences of obesity and metabolic syndrome, resulting in substantially greater incidence of nonalcoholic fatty liver disease (NAFLD). NAFLD is considered a hepatic manifestation of metabolic syndrome and is related to diabetes, insulin resistance, central obesity, hyperlipidemia, and hypertension. Nonalcoholic steatohepatitis (NASH) is an entity that describes liver inflammation due to NAFLD. Growing evidence suggests that NAFLD is a multisystem disease with a clinical burden that is not only confined to liver-related morbidity and mortality, but that also affects several extra-hepatic organs and regulatory pathways. Thus, NAFLD is considered an important public health issue, but there is currently no effective therapy for all NAFLD patients in the general population. Studies seeking optimal therapy for NAFLD and NASH have not yet led to development of a universal protocol for treating this growing problem. Several pharmacological agents have been studied in an effort to improve insulin resistance and the proinflammatory mediators that may be responsible for NASH progression. Cardiovascular risk factors are highly prevalent among NASH patients, and the backbone of treatment regimens for these patients still comprises general lifestyle interventions, including dietary changes and increased physical activity. Vitamin E and thiazolidinedione derivatives are currently the most evidence-based therapeutic options, but only limited clinical evidence is available regarding their long-term efficacy and safety. Vitamin D and renin-angiotensin-aldosterone system blockers are promising drugs that are currently being intensively investigated for use in NAFLD/NASH patients.

Authors+Show Affiliations

Department of Gastroenterology, UHC Rijeka, Rijeka, Croatia.Department of Gastroenterology, UHC Rijeka, Rijeka, Croatia ; Department of Nephrology, Dialysis and Kidney Transplantation, UHC Rijeka, Rijeka, Croatia.Department of Gastroenterology, UHC Rijeka, Rijeka, Croatia.Department of Hematology, UHC Rijeka, Rijeka, Croatia.Department of Gastroenterology, UHC Rijeka, Rijeka, Croatia.Department of Gastroenterology, UHC Rijeka, Rijeka, Croatia.Department for Clinical Pharmacology, University of Rijeka Medical School, UHC Rijeka, Rijeka, Croatia.Department of Nephrology, Dialysis and Kidney Transplantation, UHC Rijeka, Rijeka, Croatia.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26316717

Citation

Milic, Sandra, et al. "Nonalcoholic Steatohepatitis: Emerging Targeted Therapies to Optimize Treatment Options." Drug Design, Development and Therapy, vol. 9, 2015, pp. 4835-45.
Milic S, Mikolasevic I, Krznaric-Zrnic I, et al. Nonalcoholic steatohepatitis: emerging targeted therapies to optimize treatment options. Drug Des Devel Ther. 2015;9:4835-45.
Milic, S., Mikolasevic, I., Krznaric-Zrnic, I., Stanic, M., Poropat, G., Stimac, D., ... Orlic, L. (2015). Nonalcoholic steatohepatitis: emerging targeted therapies to optimize treatment options. Drug Design, Development and Therapy, 9, pp. 4835-45. doi:10.2147/DDDT.S64877.
Milic S, et al. Nonalcoholic Steatohepatitis: Emerging Targeted Therapies to Optimize Treatment Options. Drug Des Devel Ther. 2015;9:4835-45. PubMed PMID: 26316717.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonalcoholic steatohepatitis: emerging targeted therapies to optimize treatment options. AU - Milic,Sandra, AU - Mikolasevic,Ivana, AU - Krznaric-Zrnic,Irena, AU - Stanic,Marija, AU - Poropat,Goran, AU - Stimac,Davor, AU - Vlahovic-Palcevski,Vera, AU - Orlic,Lidija, Y1 - 2015/08/20/ PY - 2015/8/29/entrez PY - 2015/9/1/pubmed PY - 2016/6/4/medline KW - insulin resistance KW - metabolic syndrome KW - nonalcoholic fatty liver disease KW - therapy SP - 4835 EP - 45 JF - Drug design, development and therapy JO - Drug Des Devel Ther VL - 9 N2 - Diet and lifestyle changes have led to worldwide increases in the prevalences of obesity and metabolic syndrome, resulting in substantially greater incidence of nonalcoholic fatty liver disease (NAFLD). NAFLD is considered a hepatic manifestation of metabolic syndrome and is related to diabetes, insulin resistance, central obesity, hyperlipidemia, and hypertension. Nonalcoholic steatohepatitis (NASH) is an entity that describes liver inflammation due to NAFLD. Growing evidence suggests that NAFLD is a multisystem disease with a clinical burden that is not only confined to liver-related morbidity and mortality, but that also affects several extra-hepatic organs and regulatory pathways. Thus, NAFLD is considered an important public health issue, but there is currently no effective therapy for all NAFLD patients in the general population. Studies seeking optimal therapy for NAFLD and NASH have not yet led to development of a universal protocol for treating this growing problem. Several pharmacological agents have been studied in an effort to improve insulin resistance and the proinflammatory mediators that may be responsible for NASH progression. Cardiovascular risk factors are highly prevalent among NASH patients, and the backbone of treatment regimens for these patients still comprises general lifestyle interventions, including dietary changes and increased physical activity. Vitamin E and thiazolidinedione derivatives are currently the most evidence-based therapeutic options, but only limited clinical evidence is available regarding their long-term efficacy and safety. Vitamin D and renin-angiotensin-aldosterone system blockers are promising drugs that are currently being intensively investigated for use in NAFLD/NASH patients. SN - 1177-8881 UR - https://www.unboundmedicine.com/medline/citation/26316717/Nonalcoholic_steatohepatitis:_emerging_targeted_therapies_to_optimize_treatment_options_ L2 - https://dx.doi.org/10.2147/DDDT.S64877 DB - PRIME DP - Unbound Medicine ER -