Non-alcoholic fatty liver disease medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Trials are presently being conducted to optimize treatment of NASH. No standard treatment has yet emerged as the gold standard. General recommendations include improving metabolic risk factors - weight loss, treating diabetes, managing lipids - and reducing alcohol intake.
Medical Therapy
- There is no one FDA approved specific treatment for NAFLD. Multiple trails are going on to obtain specific and effective treatment for NAFLD.
- One of the largest trials of NAFLD/NASH therapy evaluated rosiglitazone, an insulin-sensitizing thiazolidinedione.[1].
- Rosiglitazone is recommended among all patients who develop NAFLD. Long term treatment with rosiglitazone in patients with NAFLD shows significant improvement.[2]
- Patients with NAFLD shows benifits when using ursodeoxycholic acid (UDCA) in combination with vitamin E improved laboratory values and hepatic steatosis of patients with NASH.[3]
- Pharmacologic medical therapies for NAFLD also include vitamin E with vitamin C which shows statstically significant improvement without any side effects in fibrosis score (p=0.002).[4]
- Vitamin E 800 mg PO /OD.[5]
- Avoid high dose of vitamin E which increases the fatality rate.
- Moringa Oleifera (MO), a plant from the family Moringacea is a major crop in Asia and Africa, the leaves of these plant have been studied extensively and it has shown to be beneficial in NAFLD and in prevention and alleviation of NAFLD.[6]
References
- ↑ Ratziu V, Giral P, Jacqueminet S, Charlotte F, Hartemann-Heurtier A, Serfaty L, Podevin P, Lacorte JM, Bernhardt C, Bruckert E, Grimaldi A, Poynard T (2008). "Rosiglitazone for nonalcoholic steatohepatitis: one-year results of the randomized placebo-controlled Fatty Liver Improvement with Rosiglitazone Therapy (FLIRT) Trial". Gastroenterology. 135 (1): 100–10. doi:10.1053/j.gastro.2008.03.078. PMID 18503774.
- ↑ "Long-term efficacy of rosiglitazone in nonalcoholic steatohepatitis: Results of the fatty liver improvement by rosiglitazone therapy (FLIRT 2) extension trial - Ratziu - 2009 - Hepatology - Wiley Online Library".
- ↑ Dufour JF, Oneta CM, Gonvers JJ, Bihl F, Cerny A, Cereda JM, Zala JF, Helbling B, Steuerwald M, Zimmermann A (2006). "Randomized placebo-controlled trial of ursodeoxycholic acid with vitamin e in nonalcoholic steatohepatitis". Clin. Gastroenterol. Hepatol. 4 (12): 1537–43. doi:10.1016/j.cgh.2006.09.025. PMID 17162245.
- ↑ Harrison SA, Torgerson S, Hayashi P, Ward J, Schenker S (2003). "Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis". Am. J. Gastroenterol. 98 (11): 2485–90. doi:10.1111/j.1572-0241.2003.08699.x. PMID 14638353.
- ↑ Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E (2005). "Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality". Ann. Intern. Med. 142 (1): 37–46. PMID 15537682.
- ↑ "pdfs.semanticscholar.org" (PDF).