TouchREVIEWS in endocrinology最新文献

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The International Evidence-based Guidelines for the Assessment and Management of Polycystic Ovary Syndrome: An Exemplar of Person-centred Care. 多囊卵巢综合症评估与管理国际循证指南》:以人为本的护理典范。
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-08-16 DOI: 10.17925/EE.2024.20.2.1
Bharti Kalra, Nitin Kapoor, Atul Dhingra, Sanjay Kalra
{"title":"The International Evidence-based Guidelines for the Assessment and Management of Polycystic Ovary Syndrome: An Exemplar of Person-centred Care.","authors":"Bharti Kalra, Nitin Kapoor, Atul Dhingra, Sanjay Kalra","doi":"10.17925/EE.2024.20.2.1","DOIUrl":"https://doi.org/10.17925/EE.2024.20.2.1","url":null,"abstract":"<p><p>In this opinion piece, we appraise the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2023 from a person-centric perspective. We discuss how the authors balance evidence with empathy and offer excellence in clinical decision-making while ensuring the empowerment of the affected individual. We note how they skilfully use powerful words and phrases to capture the essence of person-centred care. Finally, we suggest how these guidelines can be strengthened and how they can be used to create a template for guidance on the management of other chronic disorders.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"2-4"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Setmelanotide: A Melanocortin-4 Receptor Agonist for the Treatment of Severe Obesity Due to Hypothalamic Dysfunction. 塞美拉诺肽:治疗因下丘脑功能障碍导致的严重肥胖症的黑色素皮质素-4 受体激动剂。
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-02-09 DOI: 10.17925/EE.2024.20.2.9
Sulmaaz Qamar, Ritwika Mallik, Janine Makaronidis
{"title":"Setmelanotide: A Melanocortin-4 Receptor Agonist for the Treatment of Severe Obesity Due to Hypothalamic Dysfunction.","authors":"Sulmaaz Qamar, Ritwika Mallik, Janine Makaronidis","doi":"10.17925/EE.2024.20.2.9","DOIUrl":"10.17925/EE.2024.20.2.9","url":null,"abstract":"<p><p>Obesity is a silent global pandemic. It is a condition associated with multiple risk factors and adverse outcomes that arise from the intertwined relationship between environmental factors and genetics. The genetic factors that cause phenotypic expression are variable. Monogenic obesity is a severe early-onset and rarer form of obesity, which presents with co-morbidities such as abnormal feeding behaviour. Monogenic obesity causes impaired weight regulation in the hypothalamus due to defects in the leptin-melanocortin signalling pathway. The emergence of a new therapeutic treatment, the melanocortin-4 receptor agonist setmelanotide (originally RM-493), has represented a breakthrough in the management of monogenic obesity and has raised hope in managing complex obesity. This review provides an overview of the setmelanotide trials that have taken place, as well as its mechanism of action, side effects and weight loss outcomes that led to its approval in the treatment of pro-opiomelanocortin (POMC) deficiency and proprotein convertase subtilisin/kexin type 1 (PCSK1) deficiency. It also explores setmelanotide's role in other genetic forms of obesity, such as hypothalamic obesity, Prader-Willi syndrome, Alström syndrome and other rare genetic conditions that are being investigated. This review aims to help to understand the pathophysiology of genetic obesity and aid in future treatment options for people with severe, complex genetic obesity.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"62-71"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metabolic Dysfunction-associated Steatotic Liver Disease and Type 2 Diabetes: A Deadly Synergy. 代谢功能障碍相关性脂肪肝和 2 型糖尿病:致命的协同作用
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-04-23 DOI: 10.17925/EE.2024.20.2.2
Damien Leith, Yeun Yi Lin, Paul Brennan
{"title":"Metabolic Dysfunction-associated Steatotic Liver Disease and Type 2 Diabetes: A Deadly Synergy.","authors":"Damien Leith, Yeun Yi Lin, Paul Brennan","doi":"10.17925/EE.2024.20.2.2","DOIUrl":"10.17925/EE.2024.20.2.2","url":null,"abstract":"<p><p>Type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD) are both facets of the metabolic syndrome, associated with obesity and insulin resistance. MASLD, a term that replaces non-alcoholic fatty liver disease (NAFLD), occurs in up to 70% of people with T2D. Not only do T2D and MASLD commonly co-occur, but there is a synergistic, bidirectional relationship between these conditions, meaning that each affects the natural disease course of the other. As such, it is important for those caring for people with T2D to recognize the importance of this co-diagnosis. In this summary, we detail the synergistic relationship between T2D and MASLD, explain the current challenges in recognizing this common co-diagnosis and suggest practical approaches for those caring for people with T2D to improve the diagnosis and treatment of MASLD.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"5-9"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Automated Insulin Delivery in Pregnancies Complicated by Type 1 Diabetes. 在 1 型糖尿病并发妊娠中使用胰岛素自动输送系统。
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-10-09 DOI: 10.17925/EE.2024.20.2.14
Mahima Chillakanti, Elaine Young, April Hopcroft, Natalie Bellini, Jennifer Smith, Diana Isaacs
{"title":"Use of Automated Insulin Delivery in Pregnancies Complicated by Type 1 Diabetes.","authors":"Mahima Chillakanti, Elaine Young, April Hopcroft, Natalie Bellini, Jennifer Smith, Diana Isaacs","doi":"10.17925/EE.2024.20.2.14","DOIUrl":"10.17925/EE.2024.20.2.14","url":null,"abstract":"<p><p><b>Background:</b> Diabetes during pregnancy is associated with significant maternal and foetal health risks. Insulin requirements also change during pregnancy. This necessitates careful and effective management of diabetes. Although commonly used in clinical practice, the US Food and Drug Administration (FDA)-approved algorithms for automated insulin delivery (AID) systems do not have pregnancy-specific glycaemic targets. This review aims to evaluate the safety and efficacy of AID systems in reaching glycaemic targets in pregnant women with type 1 diabetes (T1D). <b>Methods:</b> In this retrospective case review, six pregnant women with T1D used three types of AID systems. Two patients used Omnipod 5, two patients used Control-I Q and two patients used Do-I t-Yourself (DIY) Loop. <b>Results:</b> Across trimesters, the two patients using Omnipod 5 had an average time in range (TIR) of 68 and 82%. Patients using Control-I Q had an average TIR of 77 and 69%. Both the patients using DIY Loop had an average TIR of 85%. Hypoglycaemia occurrence was minimal. Additionally, four of the six patients had uncomplicated vaginal deliveries in their third trimester, and four of the six patients achieved guideline-r ecommended TIR targets. Birth complications for the other two patients were resolved shortly after birth. Throughout the pregnancies, insulin needs approximately doubled. <b>Conclusions:</b> AID systems can achieve near-desired glycaemic targets with minimal hypoglycaemia in pregnant women with T1D. Randomized controlled trials are needed to confirm these findings and to win FDA indications in pregnancy.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"110-118"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New Insights into the Pleiotropic Actions of Dipeptidyl Peptidase-4 Inhibitors Beyond Glycaemic Control. 二肽基肽酶-4 抑制剂在控制血糖之外的多效应新见解。
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-09-06 DOI: 10.17925/EE.2024.20.2.5
Safwat A Mangoura, Marwa A Ahmed, Andrew Z Zaka
{"title":"New Insights into the Pleiotropic Actions of Dipeptidyl Peptidase-4 Inhibitors Beyond Glycaemic Control.","authors":"Safwat A Mangoura, Marwa A Ahmed, Andrew Z Zaka","doi":"10.17925/EE.2024.20.2.5","DOIUrl":"10.17925/EE.2024.20.2.5","url":null,"abstract":"<p><p>Dipeptidyl peptidase-4 (DPP-4) is a multifunctional serine ectopeptidase that cleaves and modifies a plethora of substrates, including regulatory peptides, cytokines and chemokines. DPP-4 is implicated in the regulation of immune response, viral entry, cellular adhesion, metastasis and chemotaxis. Regarding its numerous substrates and extensive expression inside the body, multitasking DPP-4 has been assumed to participate in different pathophysiological mechanisms. DPP-4 inhibitors or gliptins are increasingly used for the treatment of type 2 diabetes mellitus. Several reports from experimental and clinical studies have clarified that DPP-4 inhibitors exert many beneficial pleiotropic effects beyond glycaemic control, which are mediated by anti-inflammatory, anti-oxidant, anti-fibrotic and anti-apoptotic actions. The present review will highlight the most recent findings in the literature about these pleiotropic effects and the potential mechanisms underlying these benefits, with a specific focus on the potential effectiveness of DPP-4 inhibitors in coronavirus disease-19 and diabetic kidney disease.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"19-29"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New Trends in Treating Cushing's Disease. 治疗库欣病的新趋势。
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-04-08 DOI: 10.17925/EE.2024.20.2.3
Odysseas Violetis, Krystallenia I Alexandraki
{"title":"New Trends in Treating Cushing's Disease.","authors":"Odysseas Violetis, Krystallenia I Alexandraki","doi":"10.17925/EE.2024.20.2.3","DOIUrl":"10.17925/EE.2024.20.2.3","url":null,"abstract":"<p><p>Rates of recurrence and/or persistence of Cushing's disease after surgical treatment are high. Recently, advances in molecular insights and a better understanding of pathophysiology have enabled the development of potential therapeutic targets that could control adrenocorticotropic hormone (ACTH) and cortisol secretion or even reduce tumour cell proliferation. At the pituitary level, pasireotide is an approved somatostatin receptor ligand, and compounds targeting cell cycle regulation, cell signalling and epigenetics are now under investigation. Levoketoconazole and osilodrostat are novel steroid inhibitors, and relacorilant overcomes the adverse effects of mifepristone. Adrenal ACTH receptor blockage and immunotherapy could also play a role.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"10-15"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Horizon of Thyroid Imaging Reporting and Data System in the Diagnostic Performance of Thyroid Nodules: Clinical Application and Future Perspectives. 甲状腺成像报告和数据系统在甲状腺结节诊断中的地平线:临床应用与未来展望
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-07-12 DOI: 10.17925/EE.2024.20.2.11
Seyedeh Niloofar Sharafi, Mohammad Moarefzadeh, Milad Tari Moradi
{"title":"The Horizon of Thyroid Imaging Reporting and Data System in the Diagnostic Performance of Thyroid Nodules: Clinical Application and Future Perspectives.","authors":"Seyedeh Niloofar Sharafi, Mohammad Moarefzadeh, Milad Tari Moradi","doi":"10.17925/EE.2024.20.2.11","DOIUrl":"10.17925/EE.2024.20.2.11","url":null,"abstract":"<p><p>The widespread occurrence of thyroid nodules and the typically slow progression of thyroid cancer have led to the development of the thyroid imaging reporting and data system (TI-RADS). The primary objectives behind the development of TI-RADS were to minimize unnecessary biopsies of non-cancerous nodules, enhance the overall precision of diagnosis and establish a uniform risk-stratification framework based on the lexicon to notify healthcare professionals of nodules that require a biopsy. The identification and precise diagnosis of thyroid nodules have led to improved clinical practice examination reports within the general population. TI-RADS is a risk-stratification system related to thyroid lesions and based on ultrasound characteristics and is similar to the structure of the breast imaging reporting and data system. There are various versions of TI-RADS, with some being widely used and adequately validated, while others lacking thorough evaluation. TI-RADS uses a numerical scoring system for characteristics, and its categories are determined by the cumulative score of a thyroid nodule, indicating the likelihood of it being benign or malignant. In this article, the various TI-RADS systems were examined as a successful method for producing precise and comprehensive documentation, with a particular emphasis on their functionality, similarities, distinctions and potential future developments.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"81-90"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Amyloid Goiter: A Peruvian Case Series. 淀粉样变性甲状腺肿:秘鲁病例系列
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-04-02 DOI: 10.17925/EE.2024.20.2.16
José Paz-Ibarra, Marcio Concepción-Zavaleta, Juan Eduardo Quiroz-Aldave, José Somocurcio-Peralta, María Belén Tite Haro, Paola Solis-Pazmino
{"title":"Amyloid Goiter: A Peruvian Case Series.","authors":"José Paz-Ibarra, Marcio Concepción-Zavaleta, Juan Eduardo Quiroz-Aldave, José Somocurcio-Peralta, María Belén Tite Haro, Paola Solis-Pazmino","doi":"10.17925/EE.2024.20.2.16","DOIUrl":"10.17925/EE.2024.20.2.16","url":null,"abstract":"<p><p><b>Introduction</b>: Amyloid goiter (AG) is a rare cause of thyroid swelling, characterized by deposits of amyloid protein in the thyroid tissue. It can be associated with primary or secondary amyloidosis. Its prevalence in multinodular goiter cases is 0.17%, with rare clinical detection before surgery. <b>Case series:</b> This Peruvian case series comprised three female patients and one male patient, with ages ranging from 28 to 65 years. All individuals had pre-existing inflammatory diseases and reported symptoms including dyspnoea, dysphagia and dysphonia. Upon physical examination, all patients exhibited a grade III goiter. Fine-needle aspiration reported colloid goiter. Three out of the four patients underwent total thyroidectomy and histochemistry revealed AG with positive Congo red staining. <b>Discussion:</b> AG is an uncommon clinical entity. It has been reported to occur more frequently in males, with an average age of diagnosis of 40 years. In our series, we observed a broad age range of patients receiving diagnoses, spanning from 28 to 65 years, with a predominance in females. The consideration of AG should be extended to every patient with an underlying chronic systemic inflammatory disease, especially end stage renal disease. In this context, AG should be included in the differential diagnosis for patients with multinodular goiter exhibiting progressive growth and causing compressive symptoms at the cervical level without affecting thyroid function, as demonstrated in our series. <b>Conclusion:</b> AG, a rare condition, warrants suspicion in the presence of a giant goiter with an underlying systemic inflammatory disease.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"124-129"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence and Risk Factors of Heart Failure in Patients Diagnosed with Hyperthyroidism: A Systematic Review and Meta-analysis. 甲状腺功能亢进症患者心力衰竭的患病率和风险因素:系统回顾与元分析》。
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-07-22 DOI: 10.17925/EE.2024.20.2.12
Si Wei David Fan, Leong Tung Ong
{"title":"Prevalence and Risk Factors of Heart Failure in Patients Diagnosed with Hyperthyroidism: A Systematic Review and Meta-analysis.","authors":"Si Wei David Fan, Leong Tung Ong","doi":"10.17925/EE.2024.20.2.12","DOIUrl":"10.17925/EE.2024.20.2.12","url":null,"abstract":"<p><p><b>Objectives:</b> Hyperthyroidism has a significant impact on the cardiovascular system, causing thyrotoxic cardiomyopathy, which is characterized by atrial fibrillation, left ventricular hypertrophy and diastolic dysfunction, and may lead to heart failure. This study aimed to investigate the prevalence and associated risk factors for heart failure in patients with hyperthyroidism. <b>Methods:</b> A systematic literature search was conducted on PubMed, SCOPUS and Ovid SP up until April 2023. Pooled prevalence and pooled odds ratio for risk factors were calculated using the generic inverse variance method. <b>Results:</b> Studies involving 30,889 patients were included in this meta-analysis. The overall prevalence of heart failure in patients with hyperthyroidism was 8% (95% confidence interval [CI]: 6-11%). Further analyses revealed that the prevalence of heart failure in patients who underwent treatment with radioactive iodine ablation, antithyroid medication and thyroidectomy was 8% (95% CI: -1 to 16%), 6% (95% CI: 2 to 11%) and 4% (95% CI: -2 to 10%), respectively. The risk factors of heart failure in hyperthyroidism include atrial fibrillation, chronic kidney disease, anaemia, hypertension, history of stroke or transient ischaemic attack, history of coronary artery disease and diabetes mellitus. <b>Conclusion:</b> Heart failure occurs in 8% of patients with hyperthyroidism, with the most common risk factor being atrial fibrillation.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"91-99"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of Obeticholic Acid, a Farnesoid X Receptor Agonist, in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis. 奥贝胆酸(一种类法内酯 X 受体激动剂)在非酒精性脂肪肝中的作用:系统综述与元分析》。
TouchREVIEWS in endocrinology Pub Date : 2024-10-01 Epub Date: 2024-10-09 DOI: 10.17925/EE.2024.20.2.8
Abm Kamrul-Hasan, Sunetra Mondal, Lakshmi Nagendra, Thanikai Sasikanth, Afsar Ahammed, Shahin Ibn Rahman, Ashani Wickramarachchi, Naresh Parajuli, Saurav Khatiwada, Deep Dutta
{"title":"Role of Obeticholic Acid, a Farnesoid X Receptor Agonist, in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis.","authors":"Abm Kamrul-Hasan, Sunetra Mondal, Lakshmi Nagendra, Thanikai Sasikanth, Afsar Ahammed, Shahin Ibn Rahman, Ashani Wickramarachchi, Naresh Parajuli, Saurav Khatiwada, Deep Dutta","doi":"10.17925/EE.2024.20.2.8","DOIUrl":"10.17925/EE.2024.20.2.8","url":null,"abstract":"<p><p><b>Background.</b> Obeticholic acid (OCA) has emerged as a promising drug in the management of nonalcoholic fatty liver disease (NAFLD). This meta-analysis aimed to analyse the therapeutic effect of OCA on NAFLD. <b>Methods.</b> Randomized controlled trials (RCTs) involving patients with NAFLD receiving OCA in the intervention arm and placebo in the control arm were searched throughout the electronic databases. The primary outcomes were changes in non-invasive markers of hepatic fibrosis and liver histology. The secondary outcomes included changes in liver enzymes, metabolic parameters from baseline and adverse events (AEs). <b>Results.</b> Four RCTs involving 1,278 subjects met the inclusion criteria. Over 6 weeks to 18 months of clinical use, OCA outperformed placebo in resolving definite nonalcoholic steatohepatitis (odds ratio [OR] 1.60, 95% confidence interval [CI] [1.04-2.48], p=0.03) and improving fibrosis (OR 2.23, 95% CI [1.56-3.20], p<0.0001), hepatocellular ballooning (OR 1.83, 95% CI [1.35-2.47], p<0.0001) and lobular inflammation (OR 1.62, 95% CI [1.13-2.32], p=0.009). OCA did not improve the enhanced liver fibrosis score and steatosis better than placebo, and demonstrated superior efficacy compared with the placebo in reducing serum alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase levels. Although a favourable effect of OCA over placebo was seen in body-weight reduction, the OCA use was associated with adverse changes in lipid parameters. Except for the greater risk of pruritus and constipation, the AE profile was comparable between the OCA and placebo groups. <b>Conclusions.</b> OCA has a favourable efficacy in improving liver histology and liver enzymes. However, the worsening of lipid parameters and other AEs with the OCA use warrants further investigation.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"20 2","pages":"54-61"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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