Hormonal
Liraglutide (1.8 mg/day) induces histological resolution of NASH without worsening fibrosis in non-diabetic and diabetic patients, primarily by improving hepatic insulin sensitivity and reducing de novo lipogenesis, independent of weight loss magnitude.
If you have NASH, ask your doctor about liraglutide. The LEAN study showed that 1.8 mg daily significantly increased the chance of resolving liver inflammation and fat without making scarring worse, especially in those who did not have diabetes. While weight loss helps, the drug also works by directly improving how your liver handles insulin and fat production.
At the end of the study, histological resolution of NASH without worsening of fibrosis, the primary end point, was seen in 39% of the patients assigned to liraglutide versus 9% of the placebo group (p=0.02). Mechanistically, liraglutide treatment improved hepatic insulin sensitivity, with resultant reduction in hepatic endogenous glucose production, decreased hepatic de novo lipogenesis and promoted an improvement in adipose tissue insulin sensitivity with reduction of lipolysis and delivery of FFAs to the liver.
Why this rating
Based on a randomized double-blind placebo-controlled trial (LEAN) with histological endpoints, though the study was not powered to fully separate weight loss effects.
Source
Current and upcoming pharmacotherapy for non-alcoholic fatty liver disease
Yaron Rotman et al. · Gut · 2016
DOI 10.1136/gutjnl-2016-312431
More from this paper
- Pioglitazone (30 mg/day) improves NASH histology in non-diabetic patients, but its clinical use is limited by side effects including weight gain and potential cardiovascular risks.Good
- Obeticholic acid (25 mg/day) significantly improves NASH histology and fibrosis in non-cirrhotic patients, but is associated with pruritus and adverse lipid changes.Good
- Vitamin E (800 IU/day of natural RRR-alpha-tocopherol) improves NASH histology in non-diabetic patients, but carries potential risks including increased mortality and hemorrhagic stroke in broader populations.Good
Related findings · Hormonal
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- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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