Adekunle Ayooluwatomiwa Deborah, Adejumo Adeyinka, Singal Ashwani K
Department of Internal Medicine, St. Luke's Hospital, Chesterfield, Missouri, USA.
Division of Hepatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Therap Adv Gastroenterol. 2023 May 10;16:17562848231170946. doi: 10.1177/17562848231170946. eCollection 2023.
Alcohol-associated liver disease (ALD) is a complex disease with rapidly increasing prevalence. Although there are promising therapeutic targets on the horizon, none of the newer targets is currently close to an Food and Drug Administration approval. Strategies are needed to overcome challenges in study designs and conducting clinical trials and provide impetus to the field of drug development in the landscape of ALD and alcoholic hepatitis. Management of ALD is complex and should include therapies to achieve and maintain alcohol abstinence, preferably delivered by a multidisciplinary team. Although associated with clear mortality benefit in select patients, the use of early liver transplantation still requires refinement to create uniformity in selection protocols across transplant centers. There is also a need for reliable noninvasive biomarkers for prognostication. Last but not the least, strategies are urgently needed to implement integrated multidisciplinary care models for treating the dual pathology of alcohol use disorder and of liver disease for improving the long-term outcomes of patients with ALD.
酒精性肝病（ALD）是一种患病率迅速上升的复杂疾病。尽管有一些有前景的治疗靶点即将出现，但目前没有一个新靶点接近获得美国食品药品监督管理局的批准。需要采取策略来克服研究设计和开展临床试验方面的挑战，并推动ALD和酒精性肝炎领域的药物开发。ALD的管理很复杂，应包括实现和维持戒酒的疗法，最好由多学科团队提供。虽然早期肝移植在特定患者中具有明确的死亡率获益，但仍需要改进，以使各移植中心的选择方案保持一致。还需要可靠的非侵入性生物标志物用于预后评估。最后但同样重要的是，迫切需要采取策略来实施综合多学科护理模式，以治疗酒精使用障碍和肝病的双重病理，从而改善ALD患者的长期预后。
