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Comprehensive Review and Updates on Holistic Approach Towards Non-Alcoholic Fatty Liver Disease Management with Cardiovascular Disease

  • Evidence-Based Medicine, Clinical Trials and Their Interpretations (K. Nasir, Section Editor)
  • Published:
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Abstract

Purpose of Review

The global prevalence of non-alcoholic fatty liver disease (NAFLD) presents an unmet need in treating these, often asymptomatic, individuals. In this review, we summarised NAFLD management and described recent developments in non-alcoholic steatohepatitis (NASH) therapeutics that can shape the future of NAFLD.

Recent Findings

A multi-disciplinary effort in promoting sustainable lifestyle measures is paramount, with the goal of either limiting energy surplus alone or in combination with targeting downstream pathways of inflammation and fibrosis. Several antidiabetic medications like PPAR-γ agonist and glucagon-like peptide receptor agonists have beneficial effects on the metabolic profile as well as NASH histology. Vitamin E has shown promise in specific groups of patients with the haptoglobin2 allele protein. Newer drugs have demonstrated promising results in NASH resolution and fibrosis improvement such as obeticholic acid, resmetirom, aramchol, efruxifermin, aldafermin and lanifibranor. Apart from discussing the results of late stage clinical trials and the possible challenges in managing these patients with limited approved therapies, we also discussed the specific management of comorbidities (diabetes, hypertension, hyperlipidaemia, cardiovascular diseases) in NAFLD patients.

Summary

Treatment strategy needs to target improvements in liver-related outcomes and cardiometabolic profile.

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Funding

Arun Sanyal reports a grant from the Foundation for the National Institutes of Health, Grant/Award Number: RO1 DK105961.

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Authors and Affiliations

  1. Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore

    Nicholas W. S. Chew

  2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Cheng Han Ng

  3. Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore

    Mark Dhinesh Muthiah

  4. Division of Gastroenterology and Hepatology, Virginia Commonwealth University, Richmond, VA, 23298-0341, USA

    Arun J. Sanyal

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Chew, N.W.S., Ng, C.H., Muthiah, M.D. et al. Comprehensive Review and Updates on Holistic Approach Towards Non-Alcoholic Fatty Liver Disease Management with Cardiovascular Disease. Curr Atheroscler Rep 24, 515–532 (2022). https://doi.org/10.1007/s11883-022-01027-5

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