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脂肪性肝病:病理生理学和新兴的药物治疗方法
Michail Kokkorakis1, Emir Muzurović1, Špela Volčanšek1
1Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (M.K., C.S.M.); Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands (M.K.); Endocrinology Section, Department of Internal Medicine, Clinical Center of Montenegro, Podgorica, Montenegro (E.M.); Faculty of Medicine, University of Montenegro, Podgorica, Montenegro (E.M.); Department of Endocrinology, Diabetes, and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia (Š.V.); Medical Faculty Ljubljana, Ljubljana, Slovenia (Š.V.); Division of Endocrinology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon (M.C.); Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri (M.A.H.); Department of Medical Pharmacology and Physiology, School of Medicine, University of Missouri, Columbia, Missouri (M.A.H.); Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, United Kingdom (D.P.M.); Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates (D.P.M.); and Boston VA Healthcare System, Harvard Medical School, Boston, Massachusetts (C.S.M.).
与代谢功能障碍相关的脂肪性肝病 (MASLD) 和脂肪性肝炎 (MASH) 治疗正在推进,新的药物和组合疗法正在开发中. 本综述涵盖了当前的MASLD/MASH病理生理学,诊断和管理策略,包括新疗法和临床试验更新.
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:
- 脂肪性肝病 (SLD),包括与代谢功能障碍相关的脂肪性肝病 (MASLD) 和与代谢功能障碍相关的脂肪性肝炎 (MASH),是全球最常见的慢性肝病.
- SLD复杂的表型需要不断发展的诊断和治疗方法.
研究的目的:
- 总结最近在MASLD/MASH病理生理学,命名和治疗策略方面的进展.
- 审查MASLD/MASH目前的药物治疗环境,包括已批准的药物,管道候选药物和组合疗法.
- 突出非侵入性诊断工具和个性化治疗方法的重要性.
主要方法:
- 关于SLD病理生理学,诊断和管理的当前文献的全面审查.
- 对MASLD/MASH药物治疗药物的第二期和第三期临床试验状态的分析.
- 检查新的治疗目标和策略,包括药物重新用途.
主要成果:
- MASLD/MASH治疗管道正在扩大,一些单一疗法显示出边际益处,导致探索组合疗法.
- Resmetirom是最近获得FDA批准的治疗方法;其他药物旨在向MASH和纤维化,同时改善心脏代谢因素.
- 由于迫切需要新的治疗方法和现有的安全数据,重新利用现有药物是一种可行的策略.
结论:
- MASLD/MASH需要一个系统的,多器官的方法,强调跨学科的护理.
- 以不同的SLD子组为指导的个性化治疗建议对于药物治疗的进步至关重要.
- 持续的研究和临床试验对于开发有效治疗这种普遍的肝脏疾病至关重要.
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