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Review
. 2019 Apr;57(4):508-517.
doi: 10.1055/a-0784-8827. Epub 2019 Apr 9.

Nonalcoholic steatohepatitis (NASH) - current treatment recommendations and future developments

Elke Roeb  1 , Andreas Geier  2
Affiliations
Review

Nonalcoholic steatohepatitis (NASH) - current treatment recommendations and future developments

Elke Roeb et al. Z Gastroenterol. 2019 Apr.

Abstract
in English, German

Nonalcoholic fatty liver disease (NAFLD) includes nonalcoholic fatty liver (NAFL), nonalcoholic steato hepatitis (NASH) and NASH cirrhosis. NAFLD is the leading cause of liver diseases in the Western world (Central Europe, United States). The NAFLD incidence increases because of increasing type 2 diabetes and obesity. This article reviews the scientific findings of epidemiology, diagnostic, and therapeutic management of NAFLD. Lifestyle modifications (low-caloric Mediterranean diet and exercise training) to reduce weight are a major factor in the treatment of NAFLD.Pharmacological therapies may be useful in patients with NASH and fibrosis as well as nonresponders to lifestyle modifications. Currently, however, no pharmacological substances are approved for the indication NASH.

Die nichtalkoholische Fettlebererkrankung (NAFLD) umfasst die nichtalkoholische Fettleber (NAFL), die nichtalkoholische Steatohepatitis (NASH) und die NASH-Zirrhose. NAFLD ist die Hauptursache für Lebererkrankungen in der westlichen Welt (Mitteleuropa, USA). Die NAFLD-Inzidenz steigt aufgrund der Zunahme von Typ-2-Diabetes und Fettleibigkeit. Diese Übersicht fasst den aktuellen Wissensstand bezüglich Epidemiologie, Diagnose und klinischem Management von NAFLD sowie zukünftige Therapieansätze anhand aktueller Leitlinien und Studien zusammen. Life-Style-Modifikationen (kalorienarme mediterrane Diät und Ausdauertraining) zur Erzielung eines Gewichtsverlustes sind das Hauptziel im Rahmen aktueller therapeutischer Empfehlungen zu NAFLD. Eine pharmakologische Therapie könnte bei Patienten mit NASH und Fibrose sowie Non-Respondern der Life-Style-Modifikationen hilfreich sein. Aktuell sind allerdings noch keine pharmakologischen Substanzen für die Indikation NASH zugelassen.

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Conflict of interest statement

From the companies MSD, Gilead, Falk Foundation, Merz, and Intercept E.R. received fees for lectures in the hepatological field, without one of these would have had any connection to this article.Andreas Geier: Steering Committee: Gilead, Intercept, Novartis.Advisor: AbbVie, Alexion, BMS, Gilead, Intercept, Ipsen, Novartis, Pfizer, Sequana.Speaker: AbbVie, Alexion, BMS, CSL Behring, Falk, Gilead, Intercept, Merz, Novartis, Sequana.Research Grant: Exalenz (LITMUS), Intercept (NAFLD CSG), Novartis, Kibion.

MeSH terms