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Antidiabetic Drugs and Statins in Nonalcoholic Fatty Liver Disease.
J Clin Exp Hepatol. 2019 Nov-Dec; 9(6):723-730.JC

Abstract

Nonalcoholic fatty liver disease (NAFLD) has become the most prevalent liver disease worldwide. Despite its high prevalence and rising incidence, there are currently no specific targeted pharmacotherapies approved by the Food and Drug Administration (FDA) for nonalcoholic steatohepatitis (NASH). Current therapies for patients with NAFLD include lifestyle modification. Vitamin E and pioglitazone are recommended for those confirmed to have NASH. However, there are concerns about the long-term safety of both pioglitazone and vitamin E in higher doses. Metformin is essential for managing the abnormal metabolic parameters in patients with NAFLD. Glucagon-like peptide-1 analogue, sodium-dependent glucose cotransporter inhibitors, and peroxisome proliferator-activated receptor agonists have shown benefits in improving metabolic parameters and reducing hepatic lipid accumulation and inflammation. However, the role of these antidiabetic agents in specifically reversing NASH needs to be established. Indeed, statins have been underprescribed in patients with NASH owing to fear of hepatotoxicity despite coronary artery disease being a common cause of death in patients with NAFLD. Statins reduce the risk of cardiovascular morbidity and mortality in patients with NASH and dyslipidemia. However, their use specifically for treatment of NASH needs further evaluation. Optimizing the control of risk factors remains the main strategy for treatment until targeted pharmacotherapies for NASH are available.

Authors+Show Affiliations

Global Hospitals Mumbai, India.Department of Hepatology, Global Hospitals, Mumbai, India.Department of Hepatology, Global Hospitals, Mumbai, India.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31889754

Citation

Kothari, Sneha, et al. "Antidiabetic Drugs and Statins in Nonalcoholic Fatty Liver Disease." Journal of Clinical and Experimental Hepatology, vol. 9, no. 6, 2019, pp. 723-730.
Kothari S, Dhami-Shah H, Shah SR. Antidiabetic Drugs and Statins in Nonalcoholic Fatty Liver Disease. J Clin Exp Hepatol. 2019;9(6):723-730.
Kothari, S., Dhami-Shah, H., & Shah, S. R. (2019). Antidiabetic Drugs and Statins in Nonalcoholic Fatty Liver Disease. Journal of Clinical and Experimental Hepatology, 9(6), 723-730. https://doi.org/10.1016/j.jceh.2019.06.003
Kothari S, Dhami-Shah H, Shah SR. Antidiabetic Drugs and Statins in Nonalcoholic Fatty Liver Disease. J Clin Exp Hepatol. 2019 Nov-Dec;9(6):723-730. PubMed PMID: 31889754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antidiabetic Drugs and Statins in Nonalcoholic Fatty Liver Disease. AU - Kothari,Sneha, AU - Dhami-Shah,Hiteshi, AU - Shah,Samir R, Y1 - 2019/06/27/ PY - 2019/02/22/received PY - 2019/06/15/accepted PY - 2020/11/01/pmc-release PY - 2020/1/1/entrez PY - 2020/1/1/pubmed PY - 2020/1/1/medline KW - 5′ adenosine monophosphate-activated protein kinase, AMPK KW - Alanine Aminotransferase, ALT KW - Aspartate transaminase, AST KW - EASL/EASD/EASO, European Association for the Study of the Liver/European Association for the Study of Diabetes/European Association for the Study of Obesity KW - GLP-1 receptor agonist KW - LFT, liver function test KW - Non alcoholic fatty liver disease, NAFLD KW - Nonalcoholic steatohepatitis, NASH KW - PPAR agonist KW - Peroxisome proliferator-activated receptor agonist, PPAR agonist KW - SGLT2 inhibitors KW - Sodium-dependent glucose cotransporter inhibitor, SGLT-2i KW - body mass index, BMI KW - cardiovascular disease, CVD KW - dipeptidyl peptidase-4 inhibitors, DPP-4i KW - glucagon-like peptide-1 receptor agonist, GLP-1RA KW - metabolic syndrome, MetS KW - nonalcoholic fatty liver disease KW - statins KW - type 2 diabetes, T2D SP - 723 EP - 730 JF - Journal of clinical and experimental hepatology JO - J Clin Exp Hepatol VL - 9 IS - 6 N2 - Nonalcoholic fatty liver disease (NAFLD) has become the most prevalent liver disease worldwide. Despite its high prevalence and rising incidence, there are currently no specific targeted pharmacotherapies approved by the Food and Drug Administration (FDA) for nonalcoholic steatohepatitis (NASH). Current therapies for patients with NAFLD include lifestyle modification. Vitamin E and pioglitazone are recommended for those confirmed to have NASH. However, there are concerns about the long-term safety of both pioglitazone and vitamin E in higher doses. Metformin is essential for managing the abnormal metabolic parameters in patients with NAFLD. Glucagon-like peptide-1 analogue, sodium-dependent glucose cotransporter inhibitors, and peroxisome proliferator-activated receptor agonists have shown benefits in improving metabolic parameters and reducing hepatic lipid accumulation and inflammation. However, the role of these antidiabetic agents in specifically reversing NASH needs to be established. Indeed, statins have been underprescribed in patients with NASH owing to fear of hepatotoxicity despite coronary artery disease being a common cause of death in patients with NAFLD. Statins reduce the risk of cardiovascular morbidity and mortality in patients with NASH and dyslipidemia. However, their use specifically for treatment of NASH needs further evaluation. Optimizing the control of risk factors remains the main strategy for treatment until targeted pharmacotherapies for NASH are available. SN - 0973-6883 UR - https://www.unboundmedicine.com/medline/citation/31889754/Antidiabetic_Drugs_and_Statins_in_Nonalcoholic_Fatty_Liver_Disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0973-6883(19)30157-4 DB - PRIME DP - Unbound Medicine ER -
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