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Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease.
Curr Vasc Pharmacol 2018; 16(3):276-288CV

Abstract

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) affects a large proportion of the general population. The disease ranges from simple steatosis, to non-alcoholic steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma. Several drugs are used in daily clinical practice to manage the disease. However, data on their efficacy in liver histology are not consistent.

AIM

We discuss current treatment options for NAFLD and NASH and preliminary results from novel drugs under investigation.

RESULTS

Among various drugs assessed for the management of NAFLD and NASH, only pioglitazone and vitamin E have provided consistent benefits on liver histology, and are recommended by the European and American guidelines. Statins were shown to produce clinically meaningful results in patients with NAFLD or NASH. Other drugs such as metformin and polyunsaturated fatty acids that are being used in clinical practice off-label have provided benefits on terms of hepatic biochemical and diabetesrelated markers; data on liver histology with these drugs are scarce and from small studies. Several new approaches to reduce inflammation, steatosis or fibrosis have shown promising results in experimental models of NAFLD or NASH lesions and are being evaluated in humans.

CONCLUSION

Pioglitazone and vitamin E are the only drugs providing consistent benefits and are currently recommended for NASH. Various pathogenetic pathways are being targeted to reduce steatosis, inflammation and fibrosis and early data on several novel drugs are very promising. On-going human trials will unveil their true impact.

Authors+Show Affiliations

Second Propaedeutic Department of Medicine, Aristotle University, Thessaloniki, Greece.Second Propaedeutic Department of Medicine, Aristotle University, Thessaloniki, Greece.Second Propaedeutic Department of Medicine, Aristotle University, Thessaloniki, Greece.Second Propaedeutic Department of Medicine, Aristotle University, Thessaloniki, Greece.Second Propaedeutic Department of Medicine, Aristotle University, Thessaloniki, Greece.Second Propaedeutic Department of Medicine, Aristotle University, Thessaloniki, Greece. VAMC and George Washington University, Washington, DC, United States.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28676020

Citation

Imprialos, Konstantinos, et al. "Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease." Current Vascular Pharmacology, vol. 16, no. 3, 2018, pp. 276-288.
Imprialos K, Stavropoulos K, Bouloukou S, et al. Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease. Curr Vasc Pharmacol. 2018;16(3):276-288.
Imprialos, K., Stavropoulos, K., Bouloukou, S., Kerpiniotis, G., Karagiannis, A., & Doumas, M. (2018). Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease. Current Vascular Pharmacology, 16(3), pp. 276-288. doi:10.2174/1570161115666170621083744.
Imprialos K, et al. Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease. Curr Vasc Pharmacol. 2018;16(3):276-288. PubMed PMID: 28676020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current and Potential Future Pharmacological Approaches for Non- Alcoholic Fatty Liver Disease. AU - Imprialos,Konstantinos, AU - Stavropoulos,Konstantinos, AU - Bouloukou,Sofia, AU - Kerpiniotis,Georgios, AU - Karagiannis,Asterios, AU - Doumas,Michael, PY - 2017/01/13/received PY - 2017/02/07/revised PY - 2017/03/12/accepted PY - 2017/7/6/pubmed PY - 2019/2/5/medline PY - 2017/7/6/entrez KW - Non-alcoholic fatty liver disease KW - alcohol. KW - drugs KW - non-alcoholic steatohepatitis KW - pioglitazone KW - vitamin E SP - 276 EP - 288 JF - Current vascular pharmacology JO - Curr Vasc Pharmacol VL - 16 IS - 3 N2 - BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) affects a large proportion of the general population. The disease ranges from simple steatosis, to non-alcoholic steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma. Several drugs are used in daily clinical practice to manage the disease. However, data on their efficacy in liver histology are not consistent. AIM: We discuss current treatment options for NAFLD and NASH and preliminary results from novel drugs under investigation. RESULTS: Among various drugs assessed for the management of NAFLD and NASH, only pioglitazone and vitamin E have provided consistent benefits on liver histology, and are recommended by the European and American guidelines. Statins were shown to produce clinically meaningful results in patients with NAFLD or NASH. Other drugs such as metformin and polyunsaturated fatty acids that are being used in clinical practice off-label have provided benefits on terms of hepatic biochemical and diabetesrelated markers; data on liver histology with these drugs are scarce and from small studies. Several new approaches to reduce inflammation, steatosis or fibrosis have shown promising results in experimental models of NAFLD or NASH lesions and are being evaluated in humans. CONCLUSION: Pioglitazone and vitamin E are the only drugs providing consistent benefits and are currently recommended for NASH. Various pathogenetic pathways are being targeted to reduce steatosis, inflammation and fibrosis and early data on several novel drugs are very promising. On-going human trials will unveil their true impact. SN - 1875-6212 UR - https://www.unboundmedicine.com/medline/citation/28676020/Current_and_Potential_Future_Pharmacological_Approaches_for_Non__Alcoholic_Fatty_Liver_Disease_ L2 - http://www.eurekaselect.com/153478/article DB - PRIME DP - Unbound Medicine ER -