Features of nonalcoholic fatty liver disease pharmacotherapy in patients with overweight and obesity
DOI:
https://doi.org/10.14739/2310-1210.2017.4.105301Keywords:
non-alcoholic fatty liver disease, steatohepatitis, treatment, clinical trialsAbstract
The aim of the work is to analyze the specialized scientific literature for summarizing data on modern views on the NAFLD treatment.
The main goal of treatment is to prevent the progression of NAFLD process with cirrhosis and liver failure development. The lack of effective pharmacological treatment of NAFLD is the main stimulus for research of new therapeutic approaches. Some attempts are made to use drugs with different mechanisms of action and emphasize the reduction of laboratory and morphological signs of NAFLD activity. The majority of the hepatocytes destruction pathogenic mechanisms, including in NAFLD, is the membrane structures damage, and it justifies the reasonable use of drugs with repairing effect on cell membranes structure and function and inhibiting effect on hepatocytes destruction.
The review presents modern recommendations on pharmacological therapy of NAFLD. Attention is drawn to the fact that cardio-vascular complications rather than hepatic are the main cause of NAFLD patients’ death. Data from randomized clinical trials indicate that the need for further development of pharmacotherapy methods is becoming increasingly important.
Today, active development of new drugs for the therapy of NAFLD is being carried out. There are several inhibitors of apoptosis among them aimed at increasing the lifespan of hepatocytes, neurons and cardiomyocytes.
Conclusions. The primary goal of NAFLD, overweight and obesity patients’ treatment is to reduce their body weight. Pharmacological agents for pathogenetic therapy of NAFLD, which have a convincing evidence base, have not been found yet. NAFLD pathogenetic treatment is to reduce insulin resistance, oxidative and cytokine-mediated stress, reducing the levels of free fatty acid and fibrogenesis inhibition.
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