与代谢功能障碍相关的脂肪肝炎的塞马格卢提德治疗:2025年11月更新的AASLD实践指南
Meena B Bansal1, Heather Patton2,3, Timothy R Morgan4,5
1Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY.
Hepatology (Baltimore, Md.)
|November 7, 2025
概括
塞马格卢提德在治疗晚期纤维化与代谢功能障碍相关的脂肪性肝病 (MASLD) 方面表现有前途,改善肝脏组织学和纤维化. 仔细的患者选择和监测对于安全性和有效性至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD),以前称为NAFLD,是一个日益严重的健康问题.
- 目前的管理严重依赖于生活方式的改变,对于晚期的药物选择有限.
- 塞马格卢提德已经成为MASLD的潜在治疗剂.
研究的目的:
- 为MASLD管理提供关于塞马格卢提德的最新实践指南.
- 概述患者选择标准,以接受西马格卢提德治疗.
- 详细说明治疗安全性和疗效的监测策略.
主要方法:
- 对MASH.中semaglutide的ESSENCE第3期试验数据的审查.
- 使用非侵入性测试 (NIT),如VCTE,MRE和ELF用于患者选择.
- 监测治疗反应和不良事件.
主要成果:
- 在ESSENCE试验中,塞马格卢提德 (2.4 mg/周) 在MASH解析和纤维化减少方面显著改善.
- 建议进行非侵入性测试,以确定患有F2-F3纤维化的候选人.
- 常见的不良事件是胃肠道;严重的风险需要仔细监测.
结论:
- 塞马格卢提德为中度至高级纤维化MASH提供了一种新的治疗途径.
- 非侵入性检测有助于切实选择患者,减少肝脏活检的需要.
- 持续监测对于管理潜在风险和评估治疗反应至关重要.
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