Endoscopic bariatric and metabolic therapies for non‐alcoholic fatty liver disease: Evidence and perspectives

Salomone, Federico; Sharaiha, Reem Z.; Boškoski, Ivo

doi:10.1111/liv.14441

Cited by 38 publications

(30 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, the potential role of endoscopic bariatric and metabolic therapies (EBMT) in the management of fatty liver disease has been highlighted. 11 , 12 EBMT are developed to avoid the invasive nature of laparoscopic or open bariatric surgery, in contrast, reproducing similar gastrointestinal physiological alterations and therapeutic effects. 13 Among these interventions, intragastric balloon (IGB), as a space-occupying EBMT device with proven efficacy in inducing weight loss, has been used in diminishing liver volume to reduce the risks of subsequent bariatric surgery and has met with success.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intragastric Balloons in the Markers of Metabolic Dysfunction-associated Fatty Liver Disease: Results from Meta-analyses

Zou¹,

Zeng²,

Ren³

et al. 2021

Journal of Clinical and Translational Hepatology

View full text Add to dashboard Cite

Background and Aims: Nonalcoholic fatty liver disease, now renamed metabolic dysfunction-associated fatty liver disease (MAFLD), is common in obese patients. Intragastric balloon (IGB), an obesity management tool with low complication risk, might be used in MAFLD treatment but there is still unexplained heterogeneity in results across studies. Methods: We conducted a systematic search of 152 citations published up to September 2020. Meta-analyses, stratified analyses, and meta-regression were performed to evaluate the efficacy of IGB on homeostasis model assessment of insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT), and to identify patients most appropriate for IGB therapy. Results: Thirteen observational studies and one randomized controlled trial met the inclusion criteria (624 participants in total). In the overall estimate, IGB therapy significantly improved the serum markers change from baseline to follow-up [

show abstract

Section: Introductionmentioning

confidence: 99%

Efficacy of Intragastric Balloons in the Markers of Metabolic Dysfunction-associated Fatty Liver Disease: Results from Meta-analyses

Zou¹,

Zeng²,

Ren³

et al. 2021

Journal of Clinical and Translational Hepatology

View full text Add to dashboard Cite

show abstract

“…Available data suggest that intragastric balloons induce rapid weight loss, leading to improvements in NAFLD parameters at least in the short-term, whereas endoscopic sleeve gastroplasty leads to stable excess body weight loss, and can therefore represent a long-term therapeutic option (Table 2). 70 To date, no data are available for cirrhotic and transplanted patients, however we believe this might represent an effective strategy, especially in the post-transplant setting, although further investigations are needed.…”

Section: Kidney Dysfunctionmentioning

confidence: 96%

NAFLD and liver transplantation: Disease burden, current management and future challenges

2020

View full text Add to dashboard Cite

Non-alcoholic fatty liver disease (NAFLD), specifically its progressive form non-alcoholic steatohepatitis (NASH), represents the fastest growing indication for liver transplantation in Western countries. Diabetes mellitus, morbid obesity and cardiovascular disease are frequently present in patients with NAFLD who are candidates for liver transplantation. These factors require specific evaluation, including a detailed pre-surgical risk stratification, in order to improve outcomes after liver transplantation. Moreover, in the post-transplantation setting, the incidence of cardiovascular events and metabolic complications can be amplified by immunosuppressive therapy, which is a well-known driver of metabolic alterations. Indeed, patients with NASH are more prone to developing early post-transplant complications and, in the long-term, de novo malignancy and cardiovascular events, corresponding to higher mortality rates. Therefore, a tailored multidisciplinary approach is required for these patients, both before and after liver transplantation. Appropriate candidate selection, lifestyle modifications and specific assessment in the pre-transplant setting, as well as pharmacological strategies, adjustment of immunosuppression and a healthy lifestyle in the post-transplant setting, play a key role in correct management.

show abstract

“…These procedures include endoscopic sleeve gastroplasty, endoscopic small bowel bypass, and duodenal mucosal resurfacing. Although apparently safe and effective in the short term,129130 much more data on histological outcomes and adverse events are needed for their extensive clinical application.…”

Section: Treatmentmentioning

confidence: 99%

Management of non-alcoholic fatty liver disease

Petroni

Brodosi

Bugianesi

et al. 2021

BMJ

125

View full text Add to dashboard Cite

Non-alcoholic fatty liver disease is a very common medical condition, driven by a combination of genetic and lifestyle factors, ultimately producing a severe chronic liver disease and increased cardiovascular risk. Most people are asymptomatic for a long time, and their daily life is unaffected, leading to difficulty in identifying and managing people who slowly progress to non-alcoholic steatohepatitis (NASH), NASH-cirrhosis, and eventually hepatocellular carcinoma. Despite advances in the understanding of pathogenic mechanisms and the identification of liver fibrosis as the strongest factor in predicting disease progression, no specific treatments have been approved by regulatory agencies. Outside controlled trials, treatment is generally limited to lifestyle intervention aimed at weight loss. Pioglitazone remains the drug of choice to reduce progression of fibrosis in people with diabetes, although it is often used off-label in the absence of diabetes. Vitamin E is mainly used in children and may be considered in adults without diabetes. Several drugs are under investigation according to the agreed targets of reduced NASH activity without worsening of fibrosis or improving fibrosis without worsening of NASH. Anti-inflammatory, anti-fibrotic agents and metabolism modulators have been tested in either phase III or phase IIb randomized controlled trials; a few failed, and others have produced marginally positive results, but only a few are being tested in extension studies. The development of non-invasive, easily repeatable surrogate biomarkers and/or imaging tools is crucial to facilitate clinical studies and limit liver biopsy.

show abstract

Endoscopic bariatric and metabolic therapies for non‐alcoholic fatty liver disease: Evidence and perspectives

Cited by 38 publications

References 47 publications

Efficacy of Intragastric Balloons in the Markers of Metabolic Dysfunction-associated Fatty Liver Disease: Results from Meta-analyses

Efficacy of Intragastric Balloons in the Markers of Metabolic Dysfunction-associated Fatty Liver Disease: Results from Meta-analyses

NAFLD and liver transplantation: Disease burden, current management and future challenges

Management of non-alcoholic fatty liver disease

Contact Info

Product

Resources

About