Yokohama City University Graduate School of Medicine, Division of Gastroenterology, 3-9 Fuku-ura, Yokohama, Japan.
Expert Opin Emerg Drugs. 2013 Sep;18(3):279-90. doi: 10.1517/14728214.2013.811232. Epub 2013 Jul 13.
The prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) is increasing along with the worldwide epidemic of obesity and their strong association with metabolic syndrome. Currently existing pharmacological therapies include anti-oxidants, insulin-sensitizing agents, lipid-lowering drugs and cytoprotective agents, but there is a lack of consensus regarding the most effective and appropriate pharmacologic therapies for NASH. Clinical trials examining new therapeutic drugs for NASH that act via various mechanisms are being performed in several countries, and these drugs may strongly influence current NASH treatment.
This article provides a review of recent data on the safety and efficacy of existing and emerging agents for the treatment of NASH.
Ideally, treatment for NASH should not only improve liver disease, but also reduce the risks of adverse cardiovascular outcomes and the development of diabetes and cancers. However, this goal is likely to be too high in the context of clinical trials designed to obtain approval for the treatment of liver disease. The only way to achieve the goal is to accumulate the results of these relatively short-term clinical trials.
随着肥胖症在全球范围内的流行及其与代谢综合征的密切关联，非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）的患病率正在上升。目前现有的药物治疗包括抗氧化剂、胰岛素增敏剂、降脂药和细胞保护剂，但对于 NASH 最有效和最合适的药物治疗方法仍缺乏共识。目前正在多个国家开展临床试验，以研究通过各种机制作用于 NASH 的新型治疗药物，这些药物可能会对当前的 NASH 治疗产生重大影响。
本文综述了现有和新兴药物治疗 NASH 的安全性和疗效的最新数据。
理想情况下，NASH 的治疗不仅应改善肝脏疾病，还应降低不良心血管结局以及糖尿病和癌症发生的风险。然而，在为治疗肝脏疾病而设计的临床试验中，这一目标可能过高。实现这一目标的唯一方法是积累这些相对短期临床试验的结果。
