Obeticholic acid for the treatment of nonalcoholic steatohepatitis. (3rd May 2020)

• Record Type: Journal Article
• Authors: Shah, Raj A.; Kowdley, Kris V.
• Is Part Of: Expert review of gastroenterology & hepatology. Volume 14:Number 5(2020)
• Page Start: 311
• Page End: 321
• Publication Date: 2020-05-03
• Subjects: Nonalcoholic fatty liver disease -- nonalcoholic steatohepatitis -- obeticholic acid -- farnesoid X receptor -- fibroblast growth factor 19 -- liver fibrosis; Gastroenterology -- Periodicals; Liver -- Diseases -- Periodicals; 616.3
• DOI: 10.1080/17474124.2020.1748498
• Languages: English
• ISSNs: 1747-4124

Abstract

ABSTRACT: Introduction: NAFLD has grown to become the most prevalent liver disease in the world, with a quarter of the general population estimated to have the disease. NASH, characterized as NAFLD with inflammation, is associated with worsening fibrosis along with increased incidence of HCC. Despite high prevalence of this disease, no pharmacologic treatments approved by regulatory agencies are available. Areas covered: This review briefly discusses present understanding of NASH pathology and currently available treatments. We also discuss data on the role of OCA as an FXR agonist in modulating disease in NASH. A comprehensive literature search of review articles, original research articles, and prospective clinical trials from 1998 to the present was performed. Expert opinion: Based on 18-month interim findings of the REGENERATE trial, OCA likely improves fibrosis in NASH and therefore may have a beneficial effect in delaying or even preventing cirrhosis. The side effect of an atherogenic lipoprotein profile may adversely affect long-term outcomes, though studies have shown that co-administration of statins is able to mitigate this effect. OCA is likely to become an option for treatment, but the specific context within which it may be prescribed still needs to be clarified.