Research Article Details
| Article ID: | A23101 |
| PMID: | 24040873 |
| Source: | Curr Pharm Des |
| Title: | The role of oral antidiabetic agents and incretin mimetics in type 2 diabetic patients with non-alcoholic fatty liver disease. |
| Abstract: | The aim of this review is to examine the evidence on the role of antidiabetic agents in patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). In particular, metformin does not seem to have significant effects on liver histology. Glitazones improve steatosis and necro-inflammation, delay progression of fibrosis, and ameliorate glucose and lipid metabolism and subclinical inflammation. However, there is now evidence that prolonged treatment with these agents may offer no additional histological benefit and that metabolic improvement does not necessarily parallel histological improvement. Moreover, the long-term safety and efficacy of glitazones is an issue of continuing concern. Injectable glucagon-like peptide 1 (GLP-1) agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors are more recent antidiabetic agents with some promising preliminary resulst in NFLD. However, experience with their use is still very limited. In conclusion, no antidiabetic agent has hitherto been shown to exert a beneficial effect on hepatic fibrosis. However, pharmacological treatment could be considered in patients with non-alcoholic steatohepatitis (NASH) not responding to lifestyle intervention. Finally, larger long-term studies are needed to shed more light on the effect of antidiabetic treatment on NAFLD. |
| DOI: | 10.2174/13816128113196660676 |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs | |
|---|---|---|---|---|---|
| S08 | Lifestyle measures | Lifestyle intervention; weight loss; diet adaptation; dietary interventions; lifestyle modifications; Exercise | -- | -- | Details |
| S02 | Enhance lipid metabolism | triglyceride-lowering; lipid tolerance; lipid metabolism | 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) inhibitor; Decreases intestinal cholesterol absorption; FXR agonist; ACC inhibitor; FAS inhibitor; DGAT2 inhibitor; SCD-1 inhibitor | Atorvastatin; Ezetimibe; Obeticholic Acid; GS-9674; GS-0976; TVB-2640; IONIS-DGAT2rx; Aramchol; | Details |
| S03 | Anti-fibrosis | fibrosis | Angiotensin Receptor Blocker (ARB); CCR2/CCR5 antagonist; Thyroid receptor β agonist; PEGylated human FGF21 analogue; Monoclonal antibody to lysyl oxidase-like 2 (LOXL2); Galectin-3 inhibitor; FGF19 variant | Losartan; Cenicriviroc; VK-2809; MGL-3196; Pegbelfermin; Simtuzumab; GR-MD-02; NGM282 | Details |
| Diseases ID | DO ID | Disease Name | Definition | Class | |
|---|---|---|---|---|---|
| I05 | 9352 | Type 2 diabetes mellitus | A diabetes that is characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. A diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. http://en.wikipedia.org/wiki/Diabetes, http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2 | disease of metabolism/inherited metabolic disorder/ carbohydrate metabolic disorder/glucose metabolism disease/diabetes/ diabetes mellitus | Details |
| Drug ID | Drug Name | Type | DrugBank ID | Targets | Category | Latest Progress | |
|---|---|---|---|---|---|---|---|
| D225 | Metformin | Chemical drug | DB00331 | PRKAB1 inducer activator; ETEDH inhibitor; GPD1 inhibitor | Improve insulin resistance | Under clinical trials | Details |
| D579 | Emfilermin | Miscellany | -- | adipocytes | Enhance lipid metabolism | Under investigation | Details |
| D155 | Glucagon | Biological drug | DB00040 | GCGR agonist | Antidiabetic drug | Under clinical trials | Details |
| D157 | Glucophage | Chemical drug | DB00331 | -- | -- | Under clinical trials | Details |