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Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status

Nonalcoholic fatty liver disease (NAFLD) is one of the major and prevalent liver diseases from the national and global perspectives. It appears that considerable numbers of the general population have been suffering from NAFLD. When a patient with NAFLD also exhibits inflammation of the liver, the c...

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Autores principales: Roy, Partho Pratik, Mahtab, Mamun Al, Rahim, Mohammad Abdur, Yesmin, SM Sabrina, Islam, Sunan Bin, Akbar, Sheikh Mohammad Fazle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9681570/
https://www.ncbi.nlm.nih.gov/pubmed/36466097
http://dx.doi.org/10.5005/jp-journals-10018-1360
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author Roy, Partho Pratik
Mahtab, Mamun Al
Rahim, Mohammad Abdur
Yesmin, SM Sabrina
Islam, Sunan Bin
Akbar, Sheikh Mohammad Fazle
author_facet Roy, Partho Pratik
Mahtab, Mamun Al
Rahim, Mohammad Abdur
Yesmin, SM Sabrina
Islam, Sunan Bin
Akbar, Sheikh Mohammad Fazle
author_sort Roy, Partho Pratik
collection PubMed
description Nonalcoholic fatty liver disease (NAFLD) is one of the major and prevalent liver diseases from the national and global perspectives. It appears that considerable numbers of the general population have been suffering from NAFLD. When a patient with NAFLD also exhibits inflammation of the liver, the condition is regarded as nonalcoholic steatohepatitis (NASH). Nonalcoholic steatohepatitis is a pathological entity that may progress to cirrhosis of the liver (LC) and hepatocellular carcinoma (HCC). It is acceptable by all that the health burden of NAFLD and NASH is tremendous. Due to the increased prevalence of these pathologies, extensive research has been conducted regarding pathogenesis, diagnostic tools, and staging of the diseases. However, adequate and approved pharmacotherapy for these pathologies is lacking. The farnesoid receptor (FXR) is a bile acid-activated receptor. It regulates lipid, glucose, bile acid metabolism. Farnesoid receptor is also endowed with anti-inflammatory and anti-fibrotic properties on the liver. Obeticholic acid (OCA), a potent and selective FXR ligand, may become a promising molecule to combat NASH and advanced fibrosis. The present review briefly discusses the current recommendation of NASH management with available pharmacological treatments. The scope of OCA with a focus on recent data of major randomized controlled trials (RCTs) is discussed. On the basis of current data and recent interim analysis, OCA seems to improve insulin resistance, steatohepatitis, levels of alanine transaminase (ALT) and fibrosis in NASH. Dose-related adverse effects like pruritus and dyslipidemia may limit its usage. Also, its usage may be restricted in patients with NASH cirrhosis. More adequately powered RCTs that would contain NASH patients with different and heterogeneous properties would be required to develop consensus about these issues. The safety profile of different doses of OCA needs to be established in these patients as well as there remain considerable queries about these. HOW TO CITE THIS ARTICLE: Roy PP, Mahtab MA, Rahim MA, et al. Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status. Euroasian J Hepato-Gastroenterol 2022;12(Suppl 1):S46–S50.
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spelling pubmed-96815702022-12-02 Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status Roy, Partho Pratik Mahtab, Mamun Al Rahim, Mohammad Abdur Yesmin, SM Sabrina Islam, Sunan Bin Akbar, Sheikh Mohammad Fazle Euroasian J Hepatogastroenterol Review Article Nonalcoholic fatty liver disease (NAFLD) is one of the major and prevalent liver diseases from the national and global perspectives. It appears that considerable numbers of the general population have been suffering from NAFLD. When a patient with NAFLD also exhibits inflammation of the liver, the condition is regarded as nonalcoholic steatohepatitis (NASH). Nonalcoholic steatohepatitis is a pathological entity that may progress to cirrhosis of the liver (LC) and hepatocellular carcinoma (HCC). It is acceptable by all that the health burden of NAFLD and NASH is tremendous. Due to the increased prevalence of these pathologies, extensive research has been conducted regarding pathogenesis, diagnostic tools, and staging of the diseases. However, adequate and approved pharmacotherapy for these pathologies is lacking. The farnesoid receptor (FXR) is a bile acid-activated receptor. It regulates lipid, glucose, bile acid metabolism. Farnesoid receptor is also endowed with anti-inflammatory and anti-fibrotic properties on the liver. Obeticholic acid (OCA), a potent and selective FXR ligand, may become a promising molecule to combat NASH and advanced fibrosis. The present review briefly discusses the current recommendation of NASH management with available pharmacological treatments. The scope of OCA with a focus on recent data of major randomized controlled trials (RCTs) is discussed. On the basis of current data and recent interim analysis, OCA seems to improve insulin resistance, steatohepatitis, levels of alanine transaminase (ALT) and fibrosis in NASH. Dose-related adverse effects like pruritus and dyslipidemia may limit its usage. Also, its usage may be restricted in patients with NASH cirrhosis. More adequately powered RCTs that would contain NASH patients with different and heterogeneous properties would be required to develop consensus about these issues. The safety profile of different doses of OCA needs to be established in these patients as well as there remain considerable queries about these. HOW TO CITE THIS ARTICLE: Roy PP, Mahtab MA, Rahim MA, et al. Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status. Euroasian J Hepato-Gastroenterol 2022;12(Suppl 1):S46–S50. Jaypee Brothers Medical Publishers 2022-07 /pmc/articles/PMC9681570/ /pubmed/36466097 http://dx.doi.org/10.5005/jp-journals-10018-1360 Text en Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd. https://creativecommons.org/licenses/by-nc/4.0/© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review Article
Roy, Partho Pratik
Mahtab, Mamun Al
Rahim, Mohammad Abdur
Yesmin, SM Sabrina
Islam, Sunan Bin
Akbar, Sheikh Mohammad Fazle
Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status
title Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status
title_full Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status
title_fullStr Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status
title_full_unstemmed Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status
title_short Treatment of Nonalcoholic Steatohepatitis by Obeticholic Acid: Current Status
title_sort treatment of nonalcoholic steatohepatitis by obeticholic acid: current status
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9681570/
https://www.ncbi.nlm.nih.gov/pubmed/36466097
http://dx.doi.org/10.5005/jp-journals-10018-1360
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