Abstract
Non-Alcoholic Fatty Liver Disease (NAFLD), the most common liver disease, is characterized by accumulation
of fat (>5% of the liver tissue), in the absence of alcohol abuse or other chronic liver diseases. Its prevalence is increasing
because of obesity, metabolic syndrome or Type 2 Diabetes Mellitus (T2DM). NAFLD can cause liver inflammation
and progress to Non-Alcoholic Steatohepatitis (NASH), fibrosis, cirrhosis or Hepatocellular Cancer (HCC). Nevertheless,
Cardiovascular Disease (CVD) is the most common cause of morbidity and mortality in NAFLD/NASH patients.
Current guidelines suggest the use of pioglitazone both in patients with T2DM and in those without.
The newer antidiabetic drugs such as Glucagon Like Peptide-1 Receptor Agonists (GLP-1 RA), Sodium-Glucose co-
Transporter-2 inhibitors (SGLT2i), and statins plus ezetimibe, are considered safe by the guidelines, and may have a beneficial
effect on NAFLD/NASH as well as Cardiovascular Disease (CVD) morbidity and mortality.
Future drugs seem to have a potential for holding down the evolution of NAFLD and reduce liver- and CVD-related morbidity
and mortality, but they will take some years to be approved for routine use.
Until then pioglitazone, GLP-1 RA, SGLT2i, and statins plus ezetimibe, especially in combination might be useful for
treating the huge number of patients with NAFLD/NASH.
Keywords:
Non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), perspective, statins, ezetimibe,
pioglitazone, GLP1 RA, SGLT2i.
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