金属:它需要一个不同的治疗选择吗?
George W Marek1, Harmeet Malhi
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Hepatology (Baltimore, Md.)
|May 31, 2024
概括
新的指导方针将代谢功能障碍和与酒精相关的肝病 (MetALD) 定义为重叠状况. 研究正在探索MetALD的治疗方法,重点是戒断策略和脂肪性肝病有前途的药物类.
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:
- 新的指导方针引入了代谢功能障碍和与酒精相关的肝病 (MetALD) 作为代谢功能障碍相关的脂肪性肝病 (MASLD) 和与酒精相关的肝病 (ALD) 的重叠.
- 虽然许多治疗方法正在开发中,但在持续饮酒的患者中,它们的疗效和安全性在很大程度上尚未研究.
- 了解与MASLD和MetALD相关的风险对于开发有效治疗至关重要.
研究的目的:
- 审查目前对MASLD和MetALD内源性和外源性风险的理解.
- 讨论MetALD的合理治疗策略,包括对酒精使用和脂肪性肝病的干预措施.
- 确定有前途的治疗药物,并强调需要对MetALD.进行进一步研究.
主要方法:
- 对MASLD和与酒精有关的肝病现有研究的文献综述.
- 对脂肪性肝病的当前和正在发展的治疗策略的分析.
- 讨论MetALD.的风险因素和潜在的治疗干预措施.
主要成果:
- 对MetALD的治疗干预应包括生物心理社会方法,戒酒策略 (包括药物治疗),以及合理使用脂肪性肝病治疗方法.
- 对MetALD有前途的治疗类别包括基于英克雷丁的疗法,FGF21激动剂,甲状腺激素受体β激动剂,SGLT2抑制剂和针对de novo脂质生成的药物.
- 目前的研究主要支持葡萄糖类1受体激动剂和MASLD的PPAR-γ激动剂,对ALD的试验中药物有限. 对MetALD的最佳治疗方法尚不清楚.
结论:
- 有效管理MetALD需要一个多方面的方法,结合生活方式干预,戒酒和向药物治疗.
- 进一步的临床试验对于评估MASLD相关疗法的安全性和有效性在MetALD群体中至关重要.
- 阐明MetALD的特定治疗需求对于推进治疗选择和改善患者治疗结果至关重要.
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