Pioglitazione and bariatric surgery best for NASH treatment: Study

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-01-04T20:52:42+05:30 | Updated On 5 Jan 2021 11:33 AM IST

Italy: Weight loss and hepatic insulin improvement are promising approaches for the treatment of Non‐Alcoholic Steato‐Hepatitis (NASH), suggests a recent meta-analysis in the journal Diabetes, Obesity and Metabolism. According to the study, anti-diabetic drug pioglitazione and bariatric surgery are the most effective therapies for NASH treatment.

Geltrude Mingrone, Università Cattolica del Sacro Cuore Rome, Italy, and colleagues aimed to compare different therapies for NASH and determine an effectiveness hierarchy.

The meta-analysis included randomized controlled trials or prospective trials with at least 6 months follow‐up and histologically‐proven NASH in adult participants. They performed Monte Carlo simulations, each generating 10,000 data points. The results were reported as medians and 95% Credibility Intervals (CrIs). To find the effects of BMI decrement or reduction of HOMA‐IR on NAFLD Activity Score (NAS) change, a meta‐regression was also conducted.

A total of 48 eligible trials consisting of 2356 adults (55.6% men) were included.

Key findings of the study include:

· The most effective treatments in terms of NAS reduction per semester were Pioglitazone and Roux‐en‐Y Gastric‐ByPass (RYGB) (‐1.50; 95% CrI: ‐2.08, ‐1.00 for Pioglitazione and ‐1.00; 95% CrI: ‐1.70, ‐0.32 for RYGB).

· Pioglitazone was also the best therapy for steatosis and lobular inflammation reduction; RYGB was the best treatment for hepatocellular ballooning reduction, whereas antioxidants appeared to be best for fibrosis improvement.

· For each 1% decrement in BMI, NAS was reduced by 1.3%.

· Conversely, 1% reduction of HOMA‐IR index reduced NAS by 0.3% (β=0.31%).

· Treatments that were regarded as promising, such as Elafibranor, Simtuzumab, Selonsertib, Cenicriviroc, Obeticholic acid and Liraglutide did not reduce either NAS or liver fibrosis significantly.

"Antioxidants may be effective in reducing liver fibrosis. Weight loss and improvement of hepatic insulin resistance are promising approaches in the treatment of NASH," wrote the authors.

"Pioglitazone and bariatric surgery are the most effective treatments for non‐alcoholic steato‐hepatitis: a hierarchical network meta‐analysis," is published in the journal Diabetes, Obesity and Metabolism.

DOI: https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14304

Diabetes Obesity and Metabolismpioglitazionebariatric surgeryNon‐Alcoholic Steato‐Hepatitis

Source : Diabetes, Obesity and Metabolism

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751