Treatment of Nonalcoholic Steatohepatitis in Adults: Present and Future
Nonalcoholic steatohepatitis has become one of the most common liver-related health problems. This condition has been linked to an unhealthy diet and weight gain, but it can also be observed in nonobese people. The standard of care is represented by the lifestyle intervention. However, because this...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2015/732870 |
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| author | S. Gitto G. Vitale E. Villa P. Andreone |
| author_facet | S. Gitto G. Vitale E. Villa P. Andreone |
| author_sort | S. Gitto |
| collection | DOAJ |
| description | Nonalcoholic steatohepatitis has become one of the most common liver-related health problems. This condition has been linked to an unhealthy diet and weight gain, but it can also be observed in nonobese people. The standard of care is represented by the lifestyle intervention. However, because this approach has several limitations, such as a lack of compliance, the use of many drugs has been proposed. The first-line pharmacological choices are vitamin E and pioglitazone, both showing a positive effect on transaminases, fat accumulation, and inflammation. Nevertheless, vitamin E has no proven effect on fibrosis and on long-term morbidity and mortality and pioglitazone has a negative impact on weight. Other drugs have been studied such as metformin, ursodeoxycholic acid, statins, pentoxiphylline, and orlistat with only partially positive results. Among the emerging treatments, telmisartan is particularly interesting as it seems to have an impact on insulin resistance, liver steatosis, inflammation, and fibrosis. However, the pathogenesis of steatohepatitis is highly complex and is determined by different parallel hits; indeed, the association of different drugs that act on various levels has been suggested. In conclusion, lifestyle intervention should be optimised and the associations of different drugs should be tested in large studies with long-term outcomes. |
| format | Article |
| id | doaj-art-69417bc373b04901a9399ce62a590a65 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-69417bc373b04901a9399ce62a590a652025-02-03T07:25:06ZengWileyGastroenterology Research and Practice1687-61211687-630X2015-01-01201510.1155/2015/732870732870Treatment of Nonalcoholic Steatohepatitis in Adults: Present and FutureS. Gitto0G. Vitale1E. Villa2P. Andreone3Dipartimento di Gastroenterologia, Azienda Ospedaliero-Universitaria and Università di Modena e Reggio Emilia, 41125 Modena, ItalyDipartimento di Scienze Mediche e Chirurgiche, Università di Bologna e Dipartimento dell’Apparato Digerente, Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant’Orsola Malpighi, 40138 Bologna, ItalyDipartimento di Gastroenterologia, Azienda Ospedaliero-Universitaria and Università di Modena e Reggio Emilia, 41125 Modena, ItalyDipartimento di Scienze Mediche e Chirurgiche, Università di Bologna e Dipartimento dell’Apparato Digerente, Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant’Orsola Malpighi, 40138 Bologna, ItalyNonalcoholic steatohepatitis has become one of the most common liver-related health problems. This condition has been linked to an unhealthy diet and weight gain, but it can also be observed in nonobese people. The standard of care is represented by the lifestyle intervention. However, because this approach has several limitations, such as a lack of compliance, the use of many drugs has been proposed. The first-line pharmacological choices are vitamin E and pioglitazone, both showing a positive effect on transaminases, fat accumulation, and inflammation. Nevertheless, vitamin E has no proven effect on fibrosis and on long-term morbidity and mortality and pioglitazone has a negative impact on weight. Other drugs have been studied such as metformin, ursodeoxycholic acid, statins, pentoxiphylline, and orlistat with only partially positive results. Among the emerging treatments, telmisartan is particularly interesting as it seems to have an impact on insulin resistance, liver steatosis, inflammation, and fibrosis. However, the pathogenesis of steatohepatitis is highly complex and is determined by different parallel hits; indeed, the association of different drugs that act on various levels has been suggested. In conclusion, lifestyle intervention should be optimised and the associations of different drugs should be tested in large studies with long-term outcomes.http://dx.doi.org/10.1155/2015/732870 |
| spellingShingle | S. Gitto G. Vitale E. Villa P. Andreone Treatment of Nonalcoholic Steatohepatitis in Adults: Present and Future Gastroenterology Research and Practice |
| title | Treatment of Nonalcoholic Steatohepatitis in Adults: Present and Future |
| title_full | Treatment of Nonalcoholic Steatohepatitis in Adults: Present and Future |
| title_fullStr | Treatment of Nonalcoholic Steatohepatitis in Adults: Present and Future |
| title_full_unstemmed | Treatment of Nonalcoholic Steatohepatitis in Adults: Present and Future |
| title_short | Treatment of Nonalcoholic Steatohepatitis in Adults: Present and Future |
| title_sort | treatment of nonalcoholic steatohepatitis in adults present and future |
| url | http://dx.doi.org/10.1155/2015/732870 |
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