Multimorbidity and polypharmacy in diabetic patients with NAFLD

Patel, Preya; Hayward, Kelly L.; Rudra, Rathiga; Horsfall, Leigh; Hossain, Fabrina; Williams, Suzanne; Johnson, Tracey; Brown, Nigel N.; Saad, Nivene; Clouston, Andrew D.; Stuart, Katherine; Valery, Patricia C.; Irvine, Katharine M.; Russell, Anthony; Powell, Elizabeth E.

doi:10.1097/md.0000000000006761

Cited by 47 publications

(59 citation statements)

References 49 publications

(48 reference statements)

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“…Comorbidity is characteristic for NAFLD with frequent other chronic concomitant diseases. According to Patel et al (2017), the most common comorbidities are MS (94%), "depression" diagnosed by patients (44%), coronary heart disease (32%), obstructive sleep apnea (32%), and 59% cases of NAFLD with DM-2 are characterized by polypharmacy (Patel et al, 2017). Jonathan et al (2016) revealed that NAFLD and DM-2 association leads to a higher rate of treatment resistant DM-2 and diabetic microangiopathy development.…”

Section: Discussionmentioning

confidence: 99%

“…IR can lead to NAFLD and NAFLD can cause hepatic IR, so NAFLD patients are at high risk of complete MS or its development of its components especially DM-2 (Gaggini et al, 2013;Firneisz, 2014). In addition to higher probability of death due to hepatic complications (liver failure, portal hypertension complications, hepatocellular carcinoma) (Armstrong et al, 2014), those patients are prone to higher incidence of cardiovascular diseases (Patel et al, 2017). The dangerous feature of NAFLD is an asymptomatic course especially during the initial stage (hepatosteatosis) which can be presented without lab tests showing abnormalities, which makes it difficult and sometimes even impossible to diagnose in time and start the early treatment for prevention of both hepatic and extrahepatic complications.…”

Section: Introductionmentioning

confidence: 99%

“…Considering that NAFLD is characterized by comorbidity which often leads to polypharmacy (Patel et al, 2017), the medicines with multiple effects that influence different ethio-pathogenic links of clinical and laboratory presentation of NFLD should be preferred in those patients (Berlanga et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Biochemical screen correction possibilities in patients with non-alcoholic fatty liver disease with diabetes mellitus

Фейса

Ростока-Резнікова

Tovt-Korshynska

et al. 2018

Regul. Mech. Biosyst.

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The rationale for this study is the controversial data regarding the efficacy of hepatoprotectors and antioxidants for lipid profile correction in non-alcoholic fatty liver disease, the prevalence of which is increasing especially in association with diabetes mellitus. We examined 100 non-alcoholic fatty liver disease patients (40–75 years old) with concomitant type 2 diabetes mellitus (n = 73) or without it (n = 27), the groups were standardized by age and gender. In patients with non-alcoholic fatty liver disease with diabetes mellitus we revealed significantly higher rates of total cholesterol, triglycerides and atherogenic factor in association with a significantly lower high-density lipoproteins level versus the group of patients without concomitant diabetes. We recommended the modification of lifestyle as basic management of their condition to all patients, hypoglycemic therapy with metformin to persons with concomitant diabetes mellitus and rosuvastatin to patients with non-alcoholic fatty liver disease without diabetes. In addition, 25 patients received essential phospholipids (2 caps. 3 times a day) and omega-3 polyunsaturated fatty acids (1000 mg per day) for 3 months; 26 patients – α-lipoic acid (600 mg daily) for 3 months, 22 patients received rosuvastatin (10 mg daily), 27 patients with non-alcoholic fatty liver disease without diabetes mellitus received rosuvastatin (10 mg daily). We evaluated the treatment efficiency after 3 months treatment, and the remote consequences – 12 months after the start of combined treatment. After 3 months, the alanine-aminotransferase rate had decreased by 15.1% in the group taking combined essential phospholipids and ω3-polyunsaturated fatty acids and by 12.9% in the group taking alpha-lipoic acid, which was significantly larger than in the rosuvastatin group (7.5%); gamma-glutamate transpeptidase level decreased by 16.7%, 18.7% and 9.4% respectively indicating anticholestatic and hepatoprotective effect of both proposed treatment combinations. The same tendency of cytolysis and cholestasis processes inhibition was observed after 12 months as well. In conclusion, the combination of standard treatment with antioxidant and hepatoprotective agents (omega-3 polyunsaturated fatty acids with essential phospholipids or only alpha-lipoic acid) promotes both cytolysis and cholestasis syndromes inhibition in non-alcoholic fatty liver disease patients with concomitant type 2 diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Biochemical screen correction possibilities in patients with non-alcoholic fatty liver disease with diabetes mellitus

Фейса

Ростока-Резнікова

Tovt-Korshynska

et al. 2018

Regul. Mech. Biosyst.

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“…et al, 2018). Проте дисліпідемія при НАЖХП є фактором високого кардіоваскулярного ризику (Patel P.J. et al, 2017) і, згідно з рекомендаціями Європейської асоціації з вивчення захворювань печінки (European Association for the Study of the Liver -EASL), Європейської асоціації з вивчення цукрового діабету (European Association for the Study of Diabetes -EASD) та Європейської асоціації з вивчення ожиріння (European Association for the Study of Obesity -EASO), потребує призначення гіполіпідемічної фармакотерапії, найчастіше -статинів (EASL/ EASD/EASO, 2016).…”

Section: вступunclassified

“…Тому актуальним є пошук альтернативних гіполіпідемічних ліків. Враховуючи те, що НАЖХП -захворювання з характерною коморбідністю, яке часто призводить до поліпрагмазії (Patel P.J. et al, 2017), у лікуванні доцільно віддавати перевагу препаратам із багатогранною дією (Berlanga A. et al, 2014).…”

Section: вступunclassified

Зміни Лабораторних Показників У Пацієнтів Із Неалкогольною Жировою Хворобою Печінки На Фоні Предіабету Під Впливом Комплексного Лікування

Фейса¹,

університет»²

2018

UMJ

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У табл. 1 і 2: *достовірна різниця порівняно з показником до початку лікування (р≤0,05). Таблиця 2. Вплив лікування на біохімічні показники крові пацієнтів із НАЖХП на фоні предіабету Показник Група 1А (n=28) Група 1Б (n=27) До початку лікування Через 3 міс До початку лікування Через 3 міс АлАТ, МО/л 27,

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Considerations for Physiologically Based Modeling in Liver Disease: From Nonalcoholic Fatty Liver (NAFL) to Nonalcoholic Steatohepatitis (NASH)

Murphy

Adiwidjaja

Sjöstedt

et al. 2022

Clin Pharma and Therapeutics

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Nonalcoholic fatty liver disease (NAFLD), representing a clinical spectrum ranging from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), is rapidly evolving into a global pandemic. Patients with NAFLD are burdened with high rates of metabolic syndrome-related comorbidities resulting in polypharmacy. Therefore, it is crucial to gain a better understanding of NAFLD-mediated changes in drug disposition and efficacy/toxicity. Despite extensive clinical pharmacokinetic data in cirrhosis, current knowledge concerning pharmacokinetic alterations in NAFLD, particularly at different stages of disease progression, is relatively limited. In vitro-to-in vivo extrapolation coupled with physiologically based pharmacokinetic and pharmacodynamic (IVIVE-PBPK/PD) modeling offers a promising approach for optimizing pharmacologic predictions while refining and reducing clinical studies in this population. Use of IVIVE-PBPK to predict intra-organ drug concentrations at pharmacologically relevant sites of action is particularly advantageous when it can be linked to pharmacodynamic effects. Quantitative systems pharmacology/toxicology (QSP/QST) modeling can be used to translate pharmacokinetic and pharmacodynamic data from PBPK/PD models into clinically relevant predictions of drug response and toxicity. In this review, a detailed summary of NAFLDmediated alterations in human physiology relevant to drug absorption, distribution, metabolism, and excretion (ADME) is provided. The application of literature-derived physiologic parameters and ADME-associated protein abundance data to inform virtual NAFLD population development and facilitate PBPK/PD, QSP, and QST predictions is discussed along with current limitations of these methodologies and knowledge gaps. The proposed methodologic framework offers great potential for meaningful prediction of pharmacological outcomes in patients with NAFLD and can inform both drug development and clinical practice for this population.

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Multimorbidity and polypharmacy in diabetic patients with NAFLD

Abstract: Supplemental Digital Content is available in the text

Cited by 47 publications

References 49 publications

Biochemical screen correction possibilities in patients with non-alcoholic fatty liver disease with diabetes mellitus

Biochemical screen correction possibilities in patients with non-alcoholic fatty liver disease with diabetes mellitus

Зміни Лабораторних Показників У Пацієнтів Із Неалкогольною Жировою Хворобою Печінки На Фоні Предіабету Під Впливом Комплексного Лікування

Considerations for Physiologically Based Modeling in Liver Disease: From Nonalcoholic Fatty Liver (NAFL) to Nonalcoholic Steatohepatitis (NASH)

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