非酒精性脂肪性肝炎
肝硬化
医学
脂肪性肝炎
肝细胞癌
重症监护医学
表观遗传学
临床试验
生物信息学
脂肪肝
非酒精性脂肪肝
内科学
生物
疾病
生物化学
基因
作者
Brent A. Neuschwander‐Tetri
出处
期刊:Gastroenterology
[Elsevier]
日期:2020-05-01
卷期号:158 (7): 1984-1998.e3
被引量:156
标识
DOI:10.1053/j.gastro.2020.01.051
摘要
Lifestyle modifications focused on healthy eating and regular exercise are the primary recommendations for patients with nonalcoholic steatohepatitis (NASH). However, for multiple societal, psychological, physical, genetic, and epigenetic reasons, the ability of people to adopt and sustain such changes is challenging and typically not successful. To end the epidemic of NASH and prevent its complications, including cirrhosis and hepatocellular carcinoma, pharmacological interventions are now being evaluated in clinical trials. Treatments include drugs targeting energy intake, energy disposal, lipotoxic liver injury, and the resulting inflammation and fibrogenesis that lead to cirrhosis. It is likely that patients develop the phenotype of NASH by multiple mechanisms, and thus the optimal treatments of NASH will likely evolve to personalized therapy once we understand the mechanistic underpinnings of NASH in each patient. Reviewed here is the treatment landscape in this rapidly evolving field with an emphasis on drugs in Phase 2 and Phase 3 trials.
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