非酒精性脂肪肝疾病的新兴治疗选择:系统性审查
Jasmine Tidwell1, Natalie Balassiano2, Anjiya Shaikh1
1Department of Internal Medicine, University of Connecticut, Farmington, CT 06032, United States.
新疗法对非酒精性脂肪性肝病 (NAFLD) 有前途. 在人类和动物研究中,环林抑制剂,FGF21类似物和PPAR激动剂在改善肝脏健康和纤维化方面表现出有效性.
科学领域:
- 肝病学和胃肠道学
- 药理学和药物发现
- 代谢疾病 代谢疾病
背景情况:
- 非酒精性脂肪性肝病 (NAFLD) 是慢性肝病和肝移植的主要原因.
- 目前的治疗环境缺乏FDA批准的药物,需要对新型治疗剂进行研究.
- 纳夫德每年都会产生大量的医疗保健费用,这凸显了有效干预的必要性.
研究的目的:
- 评估用于NAFLD治疗的循环林抑制剂,纤维细胞生长因子21 (FGF21) 类似物和过氧体增殖器激活受体 (PPAR) 激动剂的治疗疗效.
- 在临床前和临床环境中收集和分析有关这些药物类别在临床前和临床环境中的有效性的现有数据.
- 为未来FDA批准的NAFLD治疗方法的开发提供信息.
主要方法:
- 在主要数据库 (PubMed,EMBASE,Cochrane,Scopus,Web of Science) 中进行全面的文献搜索,寻找相关研究.
- 纳入标准侧重于18岁以上患者的人类和动物研究,NIH质量评估得分高 (≥5/8).
- 不包括评论,非英语文章,儿科研究和结果或质量不充分的研究.
主要成果:
- 29项研究 (12项人类,17项动物) 符合纳入标准.
- 试验药物包括NV556 (cyclophilin 抑制剂),埃弗鲁西弗林 (FGF 激动剂),拉尼菲布拉诺 (泛PPAR 激动剂) 和萨罗格利塔萨 (双PPAR 激动剂).
- 所有研究的药物类别在动物和人类模型中都显示出稳脂症和/或纤维化的统计学上显著改善 (P < 0.05).
结论:
- 所有四种治疗类别 (cyclophilin 抑制剂,FGF21 类似物,双和泛PPAR 激动剂) 在NAFLD组织学特征上都显示出临床显著的改善.
- 这些药物在动物和人体试验中表现出良好的安全性 (P < 0.05).
- 汇编的数据支持这些药物类别可能导致FDA批准的NAFLD治疗.
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