Research Article Details
| Article ID: | A35111 |
| PMID: | 21711428 |
| Source: | Hepatol Res |
| Title: | Pharmacological therapy for non-alcoholic steatohepatitis: How efficient are thiazolidinediones? |
| Abstract: | Although diet and lifestyle changes are the first-line therapy in patients with non-alcoholic steatohepatitis (NASH), few patients are able to successfully implement these measures over the long run while others have an advanced disease requiring specific pharmacological therapy. Because insulin resistance is the underlying condition favoring the occurrence of NASH, insulin sensitizers have been tested in this condition although available trials are heterogenous in terms of choice of the drug, dosage, length of therapy and patient profile. Overall, thiazolidinediones reduce aminotransferase levels and induce a strong anti-steatogenic response. Most studies have shown an improvement in inflammation and liver cell injury while none have convincingly demonstrated an effect on fibrosis regression. The optimal duration of therapy is unknown as prolonged therapy does not seem to induce additional histological benefit. Although some tolerance issues and safety concerns, in particular cardiovascular, have been raised, thiazolidinediones are the class of drugs with the largest body of evidence in the treatment of NASH so far and can be successfully used in some patients with this disease. |
| DOI: | 10.1111/j.1872-034X.2011.00825.x |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs | |
|---|---|---|---|---|---|
| S01 | Improve insulin resistance | insulin sensitizer; insulin resistance; glucose tolerance | Biguanide: increases 5-AMP activated protein kinase signaling; SGLT-2 inhibitor; Thiazalidinedione: selective PPAR-γ agonists; GLP-1 agonist | Metformin; Empagliflozin; Canagliflozin; Rosiglitazone; Pioglitazone; Liraglutide | 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 | |
|---|---|---|---|---|---|---|---|
| D579 | Emfilermin | Miscellany | -- | adipocytes | Enhance lipid metabolism | Under investigation | Details |
| D366 | Thiazolidinediones | Chemical drug | DB11898 | -- | -- | Under clinical trials | Details |
| D083 | CLA | Chemical drug | DB01211 | KCNH2; SLCO1B1; SLCO1B3 | -- | Under clinical trials | Details |
| D182 | Insulin | Biological drug | DB00030 | INSR agonist; CPE modulator&product of | -- | Under clinical trials | Details |
| D094 | Cysteamine | Chemical drug | DB00847 | GSS stimulant | Renal drug | Under clinical trials | Details |
| D095 | Cysteamine bitartrate | Chemical drug | DB00847 | -- | -- | Under clinical trials | Details |