New therapeutic perspectives in non-alcoholic steatohepatitis

Gastroenterol Hepatol. 2018 Feb;41(2):128-142. doi: 10.1016/j.gastrohep.2017.07.006. Epub 2017 Sep 2.
[Article in English, Spanish]

Abstract

Management of non-alcoholic steatohepatitis is focused on restitution of metabolic derangement, weight loss and drugs able to improve steatosis, ballooning and fibrosis. Life-style interventions based on Mediterranean diet and increasing physical activity are the first line therapy. In patients with unsuccessful life-style intervention several drugs are under development: agonist PPAR, agonist GLP-1R and agonist FXR together with drugs focussing on inflammation, ballooning, apoptosis and fibrosis. Bariatric surgery or advanced endoscopy are reserved for morbid obese without response to life-style intervention and weighting loss drugs.

Keywords: Agonistas glucagon-like peptide-1 receptor; Body mass index; Glucagon-like peptide-1 receptor agonists; Obesidad visceral; Obeticolic acid; Peroxisome proliferator-activated receptor; Peroxisome proliferator-activated receptors; Visceral obesity; Ácido obeticólico; Índice de masa corporal.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery
  • Chenodeoxycholic Acid / analogs & derivatives
  • Chenodeoxycholic Acid / therapeutic use
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Diet, Mediterranean
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
  • Disease Management
  • Dyslipidemias / complications
  • Dyslipidemias / drug therapy
  • Endoscopy
  • Exercise Therapy
  • Gastrointestinal Microbiome
  • Glucagon-Like Peptide-1 Receptor Agonists
  • Humans
  • Insulin Resistance
  • MAP Kinase Kinase Kinase 5 / antagonists & inhibitors
  • Metabolic Syndrome / complications
  • Non-alcoholic Fatty Liver Disease / etiology
  • Non-alcoholic Fatty Liver Disease / therapy*
  • Obesity, Abdominal / complications
  • Peroxisome Proliferator-Activated Receptors / agonists
  • Receptors, Cytoplasmic and Nuclear / agonists
  • Weight Loss

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Peroxisome Proliferator-Activated Receptors
  • Receptors, Cytoplasmic and Nuclear
  • obeticholic acid
  • farnesoid X-activated receptor
  • Chenodeoxycholic Acid
  • MAP Kinase Kinase Kinase 5
  • MAP3K5 protein, human
  • Glucagon-Like Peptide-1 Receptor Agonists