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Atherosclerosis III: Management01:26

Atherosclerosis III: Management

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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
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Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Drug Therapy01:28

Drug Therapy

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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Related Experiment Video

Updated: Dec 17, 2025

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Evolving Role for Pharmacotherapy in NAFLD/NASH.

Suzanna L Attia1, Samir Softic1,2,3, Marialena Mouzaki4

  • 1Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Kentucky College of Medicine, University of Kentucky, Lexington, Kentucky, USA.

Clinical and Translational Science
|June 26, 2020
PubMed
Summary

Emerging treatments for nonalcoholic fatty liver disease (NAFLD) show promise, particularly obeticholic acid, which reduced liver fibrosis in adults with nonalcoholic steatohepatitis (NASH). Further research is ongoing for personalized pharmacotherapy.

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Area of Science:

  • Hepatology and Gastroenterology
  • Pharmacology and Drug Development
  • Metabolic Diseases

Background:

  • Nonalcoholic fatty liver disease (NAFLD) is a widespread condition affecting all ages, potentially progressing to cirrhosis and liver cancer.
  • Currently, no FDA-approved treatments exist for NAFLD, highlighting an urgent need for therapeutic interventions.
  • Active research is exploring novel pharmacotherapies targeting key pathways in NAFLD pathogenesis.

Purpose of the Study:

  • To review and summarize emerging pharmacotherapies for treating adult and pediatric nonalcoholic fatty liver disease (NAFLD).
  • To highlight promising drug candidates currently in Phase II and III clinical trials.
  • To emphasize the need for personalized treatment approaches based on NAFLD phenotypes.

Main Methods:

  • Review of ongoing and completed clinical trials for NAFLD pharmacotherapies.
  • Analysis of interim results from Phase III trials, including the REGENERATE trial.
  • Summarization of outcomes from Phase II trials investigating various drug classes.

Main Results:

  • Obeticholic acid demonstrated significant reduction in liver fibrosis in adults with NASH during the REGENERATE trial (25% vs. 12% placebo).
  • Several agents targeting bile acid signaling, insulin resistance, and lipid metabolism are under investigation.
  • Promising results from Phase II trials include agents like NGM282, liraglutide, and Empagliflozin.

Conclusions:

  • Obeticholic acid shows potential as a treatment for NASH-related fibrosis.
  • Ongoing trials like REGENERATE and MAESTRO-NASH are crucial for evaluating new NAFLD therapies.
  • A deeper understanding of NAFLD subgroups is essential for developing individualized pharmacotherapy strategies.