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在24周内对NAFLD药物干预的比较有效性:随机对照试验的传统和网络元分析

Yifan Wang¹, He Yi¹, Weixia Sun¹

¹Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China.

|March 13, 2024

概括

低血糖药物治疗对治疗非酒精性脂肪性肝病 (NAFLD),也称为代谢功能障碍相关的脂肪性肝病 (MASLD) 的治疗有希望. thiazolidinediones,维生素E加上pioglitazone,GLP-1激动剂和FGF-21类似物对NASH解决有效,而其他药物可以改善肝纤维化.

科学领域:

肝病学肝病学是一种肝病学.
药理学药理学是指药理学的学科.
代谢疾病代谢疾病

背景情况:

非酒精性脂肪性肝病 (NAFLD),现在被称为代谢功能障碍相关的脂肪性肝病 (MASLD),影响全球38%的人口.
目前,对于NAFLD/MASLD,没有FDA批准的药理疗法.
本研究旨在使用元分析评估NAFLD/MASLD的药物治疗方案.

研究的目的:

进行传统和网络元分析,以评估在NAFLD/MASLD中药物的有效性.
确定最佳的药理干预措施,以解决NASH和改善肝纤维化.
评估各种药物类别的安全性和有效性.

主要方法:

包括成人NAFLD/MASLD患者的随机化,安慰剂对照试验 (RCT),有或没有糖尿病.
使用偏差风险2 (ROB2) 工具评估RCT质量.
采用基于I2统计的随机效应或固定效应模型;网络元分析使用随机效应模型. 使用OR,大规模杀伤性武器或SMD的评估结果,CI为95%.

主要成果:

thiazolidinediones (TZDs),维生素E加上pioglitazone,GLP-1受体激动剂和FGF-21类似物在NASH解决方面表现出高效率 (SUCRA>70%).
在传统的元分析中,乙醇酸,拉尼菲布拉诺和西利马林在肝纤维化阶段 (≥1) 显著改善.
与安慰剂相比,所有评估的药物被发现相对安全.

结论:

低血糖药物治疗是NAFLD/MASLD的有效干预措施,适用于患有或没有糖尿病的患者.
推TZDs,维生素E加上pioglitazone,GLP-1受体激动剂和FGF-21类似物用于NASH解决.
肥酸,拉尼菲布拉诺和西利马林是改善NAFLD/MASLD肝纤维化的潜在选择.

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