2018年肝脏会议上的脂肪肝亮点

StephenW

Fatty liver highlights from The Liver Meeting 2018
November 27, 2018

This year at The Liver Meeting, several researchers presented data on recent advances in clinical therapeutics for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, as well as data on increasing incidence trends and discussions on the need for improved awareness.

The following reports include presentations on a thyroid receptor agonist for NASH, expert reviews on the current and upcoming clinical landscape of NAFLD therapy, and updated information on NGM282 for NASH.

Thyroid receptor agonist shows sustained response in NASH

A novel thyroid receptor agonist — MGL-3196 — showed a sustained reduction in liver fat and other markers of nonalcoholic steatohepatitis in a 36-week study, according to data presented at The Liver Meeting 2018.

“Ultimately, we saw sustained statistically significant reduction in liver fat on MRI-PDFF compared with placebo, sustained statistically significant lowering of multiple atherogenic lipids including as well as statistically significant lowering and normalization of serum liver transferases and, overall, well tolerated and safe,” Stephen A. Harrison, MD, of the University of Oxford, said during his presentation. “There was statistically significant resolution of NASH that is correlated with reduction in liver fat on MRI-PDFF and we believe this provides evidence to move forward to a registrational phase 3 trial.” Read more

VIDEO: New NAFLD data guide treatment, improve survival

In this exclusive video perspective from The Liver Meeting 2018, Zobair M. Younossi, MD, chairman of the department of medicine at Inova Fairfax Hospital in Virginia, discusses several presentations on patient reported-outcomes and mortality related to nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.

“Nonalcoholic fatty liver disease in general has three important impacts or burden, which I call comprehensive burden of nonalcoholic fatty liver disease: there’s clinical ... related to mortality and complications of cirrhosis; there’s patient-reported outcome, which is a surrogate for patient experience; and there is also research utilization,” Younossi told Healio Gastroenterology and Liver Disease. Read more

Fatty liver expert: ‘We face a moral, ethical and medical imperative’

Beyond finding a “cure” to nonalcoholic fatty liver disease, one expert at The Liver Meeting 2018 called on physicians and governments alike to fight the root cause of the disease.

“While progress is being made to control liver outcomes, this is only a band aid,” Arun Sanyal, MD, of Virginia Commonwealth University, said during the Leon Schiff State-of-the-Art Lecture. “We face a moral, ethical and medical imperative to tackle the root cause of diabetes, cardiovascular disease and NASH — ie, diet-induced obesity.” Read more

   
Aramchol reduces liver fat, improves histology in NASH

Results from a phase 2b trial showed that Aramchol— a stearoyl coenzyme desaturase A inhibitor — significantly reduced liver fat and improved histology with excellent safety and tolerability in patients with nonalcoholic fatty liver disease, according to data presented at The Liver Meeting 2018.

“Aramchol is a novel, first in class SCD1 modulator, targeted to the liver to reduce liver fat and collagen production,” Vlad Ratziu, MD, from Sorbonne University in France, said in his presentation. “In 1 year of study, Aramchol showed liver fat reduction, biochemical improvement, NASH resolution and fibrosis reduction in a dose response pattern.” Read more

Thyroid receptor agonist improves fatty liver in 91% of patients

VK2809, a thyroid receptor beta agonist, showed an impact on nearly all treated patients as measured by magnetic resonance imaging-proton density fat fraction, according to late breaking data presented at The Liver Meeting 2018.

“Up to 91% of individuals had a significant improvement in liver fat by the criteria of 30% or more in MRI-PDFF reduction,” Rohit Loomba, MD, of the University of California San Diego, said during his Late Breaker presentation. “Planning for subsequent study with biopsy-confirmed NASH is underway.” Read more

NGM282 shows equivalent efficacy in NASH at lower dose

Although previously reported effective at a 3 mg dose, NGM282 showed similar efficacy in treating nonalcoholic steatohepatitis at 1 mg, according to data presented at The Liver Meeting 2018.

“NGM282 demonstrates improvement across histologic and noninvasive endpoints in NASH. There’s potent target engagement with C4 suppression and bile acids. There are significant meaningful reductions across all noninvasive markers of NASH-related disease. And, ultimately, we see unprecedented antifibrotic activity at week 12 with both the 1 mg and 3 mg dose,” Stephen A. Harrison, MD, of University of Oxford, said during his presentation. Read more

'Mounting concern' over fatty liver as costs increase 86% over 10 years

Over 10 years, from 2005 to 2014, the number of patients with a diagnosis of nonalcoholic fatty liver disease increased by 260% and costs jumping 86%, according to data presented at The Liver Meeting 2018.

“Nonalcoholic fatty liver disease presents a mounting concern in the United States due to the increasing cost of care, length of stay and mortality rate,” Shil Patel, MD, gastroenterology fellow at CarePoint Health Medical Center, said during his presentation. “Despite medical advances in the treatment of obesity, diabetes and other related comorbidities, NAFLD continues to be a serious health problem.” Read more

StephenW

2018年肝脏会议上的脂肪肝亮点
2018年11月27日

今年在肝脏会议上，几位研究人员介绍了非酒精性脂肪性肝病和非酒精性脂肪性肝炎临床治疗方法的最新进展，以及增加发病率趋势和提高认识需求的讨论数据。

以下报告包括有关NASH甲状腺受体激动剂的介绍，NAFLD治疗当前和即将出现的临床情况的专家评论，以及有关NASH的NGM282的最新信息。

甲状腺受体激动剂在NASH中表现出持续的反应

根据肝脏会议2018年的数据，一项新的甲状腺受体激动剂 - MGL-3196--在一项为期36周的研究中显示肝脏脂肪和非酒精性脂肪性肝炎的其他标志物持续减少。

“最终，与安慰剂相比，我们发现MRI-PDFF肝脏脂肪持续显着减少，多种致动脉粥样硬化脂质持续统计学显着降低，包括血清肝转移酶的统计学显着降低和正常化，总体而言，耐受性和安全性良好， “牛津大学医学博士Stephen A. Harrison在演讲中说。 “有统计学上显着的NASH分辨率与MRI-PDFF肝脏脂肪减少相关，我们相信这提供了进入注册阶段3试验的证据。”阅读更多

视频：新的NAFLD数据指南治疗，提高生存率

在2018年肝脏会议的独家视频视角中，弗吉尼亚州Inova Fairfax医院医学系主任Zobair M. Younossi博士讨论了几例关于非酒精性脂肪性肝病和非酒精性脂肪性肝炎患者报告结果和死亡率的报告。 。

“非酒精性脂肪性肝病一般有三个重要的影响或负担，我称之为非酒精性脂肪性肝病的综合负担：临床......与肝硬化的死亡率和并发症有关;有患者报告的结果，这是患者体验的代名词;还有研究应用，“Younossi告诉Healio Gastroenterology and Liver Disease。阅读更多

脂肪肝专家：'我们面临道德，道德和医疗方面的挑战'

除了寻找非酒精性脂肪性肝病的“治愈方法”之外，2018年肝脏会议的一位专家呼吁医生和政府都要对抗这种疾病的根本原因。

弗吉尼亚联邦大学的医学博士Arun Sanyal在Leon Schiff最先进的讲座中说：“虽然在控制肝脏结果方面正在取得进展，但这只是一种乐队援助。” “我们面临道德，道德和医疗方面的迫切需要，以解决糖尿病，心血管疾病和NASH的根本原因 - 即饮食引起的肥胖症。”阅读更多

Aramchol减少肝脏脂肪，改善NASH的组织学

根据肝脏会议2018年的数据，一项2b期试验的结果显示，Aramchol-一种硬脂酰辅酶去饱和酶A抑制剂 - 显着降低了肝脏脂肪，改善了组织学，对非酒精性脂肪性肝病患者具有极佳的安全性和耐受性。

“Aramchol是一种新型的，一流的SCD1调节剂，针对肝脏以减少肝脏脂肪和胶原蛋白的产生，”来自法国索邦大学的医学博士Vlad Ratziu在他的演讲中表示。 “在1年的研究中，Aramchol显示肝脏脂肪减少，生化改善，NASH消退和纤维化减少的剂量反应模式。”阅读更多

甲状腺受体激动剂可改善91％患者的脂肪肝

根据2018年肝脏会议上提供的晚期破裂数据，VK2809是一种甲状腺受体β激动剂，通过磁共振成像 - 质子密度脂肪分数测量显示对几乎所有治疗患者的影响。

加利福尼亚大学圣地亚哥分校的Rohit Loomba博士在他的“晚间破坏者”演讲中表示，“多达91％的人在肝脏脂肪方面有显着改善，其中MRI-PDFF减少的标准为30％或更多”。 “通过活组织检查证实NASH的后续研究计划正在进行中。”阅读更多内容

NGM282在较低剂量下显示出在NASH中的等效功效

根据肝脏会议2018年提供的数据，虽然之前报道的3 mg剂量有效，但NGM282在1 mg治疗非酒精性脂肪性肝炎方面表现出相似的疗效。

“NGM282在NASH的组织学和非侵袭性终点中表现出改善。与C4抑制和胆汁酸有强烈的目标接触。 NASH相关疾病的所有非侵入性标志物均有显着的显着降低。并且，最终，我们在12周时看到前所未有的抗纤维化活性，1毫克和3毫克剂量，“牛津大学医学博士斯蒂芬A.哈里森在他的演讲中说。阅读更多

由于成本在10年内增加了86％，因此对脂肪肝的关注度越来越高

根据2018年肝脏会议上提供的数据，从2005年到2014年，超过10年，诊断为非酒精性脂肪性肝病的患者人数增加了260％，费用增加了86％。

“由于护理成本，住院时间和死亡率的增加，非酒精性脂肪性肝病在美国引起越来越多的关注，”CarePoint健康医疗中心的胃肠病学研究员Shil Patel医师在他的演讲中表示。 “尽管在治疗肥胖症，糖尿病和其他相关合并症方面取得了医学进展，但NAFLD仍然是一个严重的健康问题。”阅读更多

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