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Current and emerging pharmacological options for the treatment of nonalcoholic steatohepatitis

Authors
 Stergios A Polyzos  ;  Eun Seok Kang  ;  Chrysoula Boutari  ;  Eun-Jung Rhee  ;  Christos S Mantzoros 
Citation
 METABOLISM-CLINICAL AND EXPERIMENTAL, Vol.111(Suppl) : 154203, 2020-10 
Journal Title
 METABOLISM-CLINICAL AND EXPERIMENTAL 
ISSN
 0026-0495 
Issue Date
2020-10
MeSH
Animals ; Clinical Trials, Phase III as Topic ; Humans ; Non-alcoholic Fatty Liver Disease / drug therapy* ; Non-alcoholic Fatty Liver Disease / metabolism ; PPAR alpha / metabolism ; Quinolines / metabolism ; Sulfonamides / metabolism
Keywords
Farnesoid X receptor agonist ; Fibrosis ; Nonalcoholic fatty liver disease ; Nonalcoholic steatohepatitis ; Thiazolidinediones ; Treatment
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent disease and important unmet medical need. Current guidelines recommend, under specific restrictions, pioglitazone or vitamin E in patients with NASH and significant fibrosis, but the use of both remains off-label. We summarize evidence on medications for the treatment of nonalcoholic steatohepatitis (NASH), since NASH has been mainly associated with higher morbidity and mortality. Some of these medications are currently in phase 3 clinical trials, including obeticholic acid (a farnesoid X receptor agonist), elafibranor (a peroxisome proliferator activated receptor [PPAR]-α/δ dual agonist), cenicriviroc (a CC chemokine receptor antagonist), MSDC-0602 K (a PPAR sparing modulator), selonsertib (an apoptosis signal-regulating kinase-1 inhibitor) and resmetirom (a thyroid hormone receptor agonist). A significant research effort is also targeting PPARs and selective PPAR modulators, including INT131 and pemafibrate, with the expectation that novel drugs may have beneficial effects similar to those of pioglitazone, but without the associated adverse effects. Whether these and other medications could offer tangible therapeutic benefits, alone or in combination, apparently on a background of lifestyle modification, i.e. exercise and a healthy dietary pattern (e.g. Mediterranean diet) remain to be proven. In conclusion, major advances are expected for the treatment of NASH.
Full Text
https://www.sciencedirect.com/science/article/pii/S0026049520300676
DOI
10.1016/j.metabol.2020.154203
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180039
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