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What Does the Future Hold for Non-Alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis?

[ Vol. 17 , Issue. 5 ]

Author(s):

Michael Doumas, Konstantinos Imprialos, Konstantinos Stavropoulos and Vasilios G. Athyros*   Pages 425 - 428 ( 4 )

Abstract:


Non-Alcoholic Fatty Liver Disease (NAFLD), the most common liver disease, is characterized by accumulation of fat (>5% of the liver tissue), in the absence of alcohol abuse or other chronic liver diseases. Its prevalence is increasing because of obesity, metabolic syndrome or Type 2 Diabetes Mellitus (T2DM). NAFLD can cause liver inflammation and progress to Non-Alcoholic Steatohepatitis (NASH), fibrosis, cirrhosis or Hepatocellular Cancer (HCC). Nevertheless, Cardiovascular Disease (CVD) is the most common cause of morbidity and mortality in NAFLD/NASH patients. Current guidelines suggest the use of pioglitazone both in patients with T2DM and in those without.

The newer antidiabetic drugs such as Glucagon Like Peptide-1 Receptor Agonists (GLP-1 RA), Sodium-Glucose co- Transporter-2 inhibitors (SGLT2i), and statins plus ezetimibe, are considered safe by the guidelines, and may have a beneficial effect on NAFLD/NASH as well as Cardiovascular Disease (CVD) morbidity and mortality.

Future drugs seem to have a potential for holding down the evolution of NAFLD and reduce liver- and CVD-related morbidity and mortality, but they will take some years to be approved for routine use.

Until then pioglitazone, GLP-1 RA, SGLT2i, and statins plus ezetimibe, especially in combination might be useful for treating the huge number of patients with NAFLD/NASH.

Keywords:

Non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), perspective, statins, ezetimibe, pioglitazone, GLP1 RA, SGLT2i.

Affiliation:

VAMC and George Washington University, Washington, DC, VAMC and George Washington University, Washington, DC, VAMC and George Washington University, Washington, DC, 2nd Prop. Department of Internal Medicine, Hippocration Hospital, Medical School of Aristotle University Thessaloniki, Thessaloniki



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