FGF21 类似物治疗代谢功能障碍相关性脂肪性肝炎的有效性和安全性:系统综述与荟萃分析。

IF 3.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Fabiana Dolovitsch de Oliveira, Samira Mohamad Khalil, Emmily Daiane Buarque de Santana Sato, Matheus Henrique Gonçalves de Souza, Gilmara Coelho Meine
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引用次数: 0

摘要

简介:成纤维细胞生长因子21(FGF21)类似物可能对代谢功能障碍相关性脂肪性肝炎(MASH)患者有益。我们的目的是在随机对照试验(RCT)中比较 FGF21 类似物与安慰剂治疗 MASH 患者的疗效和安全性:我们检索了 PubMed、Embase 和 Cochrane 图书馆。主要结果为纤维化改善≥1期且MASH不恶化,以及MASH缓解且纤维化不恶化。次要结果是通过磁共振成像衍生质子密度脂肪分数(MRI-PDFF)测量的肝脏脂肪分数(HFF)相对减少≥30%和不良事件(AEs):结果:我们纳入了 7 项 RCT(886 名患者)。与安慰剂相比,FGF21类似物在纤维化改善≥1期而MASH不恶化(RR 1.54;95%CI 1.07,2.22)、MASH缓解而纤维化不恶化(RR 3.31;95%CI 1.80,6.06)以及通过MRI-PDFF使HFF减少≥30%(RR 3.03;95%CI 2.12,4.33)的几率更高,但AEs风险无显著差异。按纤维化分期进行的亚组分析显示,FGF21类似物仅能改善纤维化分期为F1-F3期的患者的纤维化状况:FGF21类似物似乎是MASH患者的一种有效、安全的治疗选择,但对纤维化改善的影响可能仅限于非肝硬化患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy and Safety of Fibroblast Growth Factor 21 Analogues for Metabolic Dysfunction-Associated Steatohepatitis: A Systematic Review and Meta-Analysis.

Introduction: Fibroblast growth factor 21 (FGF21) analogues may benefit patients with metabolic dysfunction-associated steatohepatitis (MASH). We aimed to compare the efficacy and safety of FGF21 analogues versus placebo for treating patients with MASH in randomized controlled trials (RCTs).

Methods: We searched PubMed, Embase, and the Cochrane Library. Primary outcomes were fibrosis improvement ≥1 stage without worsening of MASH and MASH resolution without worsening of fibrosis. Secondary outcomes were relative reduction ≥30% of the hepatic fat fraction (HFF) measured by magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) and adverse events (AEs).

Results: We included 7 RCTs (886 patients). FGF21 analogues had a higher probability of fibrosis improvement ≥1 stage without worsening of MASH (RR: 1.54; 95% CI: 1.07, 2.22), MASH resolution without worsening of fibrosis (RR: 3.31; 95% CI: 1.80, 6.06), and reduction ≥30% in the HFF by MRI-PDFF (RR: 3.03; 95% CI: 2.12, 4.33) than placebo, without significant difference in the risk of AEs. Subgroup analyses by the stage of fibrosis showed that FGF21 analogues improved fibrosis only among patients with fibrosis stages F1-F3.

Conclusion: FGF21 analogues appear to be an effective and safe treatment option for patients with MASH, although the impact on fibrosis improvement may be limited to non-cirrhotic patients.

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来源期刊
Annals of Nutrition and Metabolism
Annals of Nutrition and Metabolism 医学-内分泌学与代谢
CiteScore
6.50
自引率
0.00%
发文量
55
审稿时长
6-12 weeks
期刊介绍: ''Annals of Nutrition and Metabolism'' is a leading international peer-reviewed journal for sharing information on human nutrition, metabolism and related fields, covering the broad and multidisciplinary nature of science in nutrition and metabolism. As the official journal of both the International Union of Nutritional Sciences (IUNS) and the Federation of European Nutrition Societies (FENS), the journal has a high visibility among both researchers and users of research outputs, including policy makers, across Europe and around the world.
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