Treatment of Fatty Liver Disease: The Present and the Future

Ramanan, Sruthi; Mohamed, Mohamed Wael F; Aung, Su Sandi; Sange, Ibrahim; Hamid, Pousette

doi:10.7759/cureus.12713

Cited by 7 publications

(7 citation statements)

References 38 publications

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“…40 Addressing this need through educational interventions would ensure that specialists acquire the skills and resources to remain at the forefront of innovative care when treatment breakthroughs occur. 41,42 Lifestyle modifications (e.g. weight management, exercise) have shown to improve the health of patients with NASH.…”

Section: Discussionmentioning

confidence: 99%

“…This presents a clinical practice gap, since at the same time, there is a need for specialists to improve their knowledge of, and engagement with, emerging research using non‐invasive human modelling, for example, 39 and other technologies currently in development 40 . Addressing this need through educational interventions would ensure that specialists acquire the skills and resources to remain at the forefront of innovative care when treatment breakthroughs occur 41,42 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical practice gaps and challenges in non‐alcoholic steatohepatitis care: An international physician needs assessment

Lazure

Tomlinson

Kowdley

et al. 2022

Liver International

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Background and aims: Even as several pharmacological treatments for non-alcoholic steatohepatitis (NASH) are in development, the incidence of NASH is increasing on an international scale. We aim to assess clinical practice gaps and challenges of hepatologists and endocrinologists when managing patients with NASH in four countries (Germany/Italy/United Kingdom/United States) to inform educational interventions.Methods: A sequential mixed-method design was used: qualitative semi-structured interviews followed by quantitative online surveys. Participants were hepatologists and endocrinologists practising in one of the targeted countries. Interview data underwent thematic analysis and survey data were analysed with chi-square and Kruskal-Wallis tests.Results: Most interviewees (n = 24) and surveyed participants (89% of n = 224) agreed that primary care must be involved in screening for NASH, yet many faced challenges involving and collaborating with them. Endocrinologists reported low knowledge of which blood markers to use when suspecting NASH (56%), when to order an MRI (65%) or ultrasound/FibroScan® (46%), and reported sub-optimal skills interpreting alanine aminotransferase (ALT, 37%) and aspartate aminotransferase (AST, 38%) blood marker test results, causing difficulty during diagnosis. Participants believed that more evidence is needed for upcoming therapeutic agents; yet, they reported sub-optimal knowledge of eligibility criteria for clinical trials. Knowledge and skill gaps when managing comorbidities, as well as skill gaps facilitating patient lifestyle changes were reported. Conclusions: Educational interventions are needed to address the knowledge and skill gaps identified and to develop strategies to optimize patient care, which include implementing relevant care pathways, encouraging referrals and testing, and | 1773 LAZURE et aL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical practice gaps and challenges in non‐alcoholic steatohepatitis care: An international physician needs assessment

Lazure

Tomlinson

Kowdley

et al. 2022

Liver International

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“…However, current knowledge allows the provision of effective management of NAFLD as a complex metabolic disorder, often associated with IR, obesity, and DM. There are several main targets in NAFLD treatments: (1) lifestyle modification, which includes changes in feeding behavior, healthy diet, and exercise, oriented around weight loss; (2) control and management of the cardiovascular risks (the leading cause of mortality among NAFLD patients); and (3) prevention of the NAFLD progression to more severe forms and development of associated complications [ 6 ]. Ideal treatment should combine glucose and lipid-lowering drugs, metabolism modulators, antioxidants, and anti-inflammatory and anti-fibrotic agents [ 209 ].…”

Section: Therapymentioning

confidence: 99%

“…Despite its critical importance, the effective treatment for NAFLD is still missing. However, many drugs are ongoing clinical trials [ 6 ]. Early and precise diagnostic criteria are crucial for effective therapy, today relying on lifestyle interventions and the amelioration of NAFLD-related complications [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Mitochondrial Mutations and Genetic Factors Determining NAFLD Risk

Dabravolski

Bezsonov

Baig

et al. 2021

IJMS

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NAFLD (non-alcoholic fatty liver disease) is a widespread liver disease that is often linked with other life-threatening ailments (metabolic syndrome, insulin resistance, diabetes, cardiovascular disease, atherosclerosis, obesity, and others) and canprogress to more severe forms, such as NASH (non-alcoholic steatohepatitis), cirrhosis, and HCC (hepatocellular carcinoma). In this review, we summarized and analyzed data about single nucleotide polymorphism sites, identified in genes related to NAFLD development and progression. Additionally, the causative role of mitochondrial mutations and mitophagy malfunctions in NAFLD is discussed. The role of mitochondria-related metabolites of the urea cycle as a new non-invasive NAFLD biomarker is discussed. While mitochondria DNA mutations and SNPs (single nucleotide polymorphisms) canbe used as effective diagnostic markers and target for treatments, age and ethnic specificity should be taken into account.

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“…Specific treatment of NAFLD is in its nascent stages [99]. It is clear that weight loss is not necessary to reverse NAFLD; NAFLD can be addressed with a low carbohydrate, high protein, high fiber diet [100,101], or fructose-limited diet [102].…”

Section: Targeted Reversalmentioning

confidence: 99%