Non-alcoholic fatty liver disease medical therapy
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Editor in Chief: Elliot Tapper, M.D., Beth Israel Deaconess Medical Center, C. Michael Gibson, M.S., M.D. [1]
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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 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]
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.