ONO Masafumi    Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine    Position
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Antidiabetic Therapy in the Treatment of Nonalcoholic Steatohepatitis.
Journal	Formal name：International journal of molecular sciences Abbreviation：Int J Mol Sci ISSN code：14220067/14220067
Domestic / Foregin	Foregin
Volume, Issue, Page	21(6),pp.1907
Author and coauthor	Sumida Yoshio, Yoneda Masashi, Tokushige Katsutoshi, Kawanaka Miwa, Fujii Hideki, Yoneda Masato, Imajo Kento, Takahashi Hirokazu, Eguchi Yuichiro, Ono Masafumi, Nozaki Yuichi, Hyogo Hideyuki, Koseki Masahiro, Yoshida Yuichi, Kawaguchi Takumi, Kamada Yoshihiro, Okanoue Takeshi, Nakajima Atsushi, Jsg-Nafld Japan Study Group Of Nafld
Publication date	2020/03
Summary	Liver-related diseases are the third-leading causes (9.3%) of mortality in type 2 diabetes (T2D) in Japan. T2D is closely associated with nonalcoholic fatty liver disease (NAFLD), which is the most prevalent chronic liver disease worldwide. Nonalcoholic steatohepatitis (NASH), a severe form of NAFLD, can lead to hepatocellular carcinoma (HCC) and hepatic failure. No pharmacotherapies are established for NASH patients with T2D. Though vitamin E is established as a first-line agent for NASH without T2D, its efficacy for NASH with T2D recently failed to be proven. The effects of pioglitazone on NASH histology with T2D have extensively been established, but several concerns exist, such as body weight gain, fluid retention, cancer incidence, and bone fracture. Glucagon-like peptide 1 (GLP-1) receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors are expected to ameliorate NASH and NAFLD (LEAN study, LEAD trial, and E-LIFT study). Among a variety of SGLT2 inhibitors, dapagliflozin has already entered the phase 3 trial (DEAN study). A key clinical need is to determine the kinds of antidiabetic drugs that are the most appropriate for the treatment of NASH to prevent the progression of hepatic fibrosis, resulting in HCC or liver-related mortality without increasing the risk of cardiovascular or renal events. Combination therapies, such as glucagon receptor agonist/GLP-1 or gastrointestinal peptide/GLP-1, are under development. This review focused on antidiabetic agents and future perspectives on the view of the treatment of NAFLD with T2D.
DOI	10.3390/ijms21061907
PMID	32168769