Management of NASH Treatment nonalcoholic steatohepatitis
Explore the latest advancements in NASH treatment with our comprehensive video library, focusing on innovative NASH therapies and effective management strategies.
Learn about the current approaches to reducing NASH-related mortality, preventing progression to cirrhosis, and avoiding hepatocellular carcinoma (HCC). Although no FDA or EMA-approved therapies for NASH exist yet, our video collection highlights the importance of lifestyle interventions and offers insights into the evolving landscape of NASH management.
Stay informed and empower your practice with the most up-to-date information on NASH treatment options.
RELATED Nash treatment and therapies VIDEOS
The Odyssey for an Optimal NASH Biomarker: Challenges and Opportunities in 2023
Explore the challenges and opportunities in the quest for a non-invasive diagnosis tool of non-alcoholic
How to Integrate NASH Assessment and Management Into the Care of Diabetic Patient
Dr. Laurent Castera (France) discusses how healthcare professionals can integrate non-alcoholic steatohepatitis (NASH) assessment and
NASH Management in 2022: benefits of lifestyle recommendations, including nutrition and exercise
Prof. Stephen Harrison (USA) discusses state of the art management of non-alcoholic steatohepatitis (NASH) in
Getting to the Heart of NAFLD and NASH – The international CVD Perspective (part. 4)
This video presents a comprehensive review of non-alcoholic fatty liver disease (NAFLD) & non-alcoholic steatohepatitis (NASH), delivered
Lifestyle interventions
The close relationship between unhealthy lifestyle and NAFLD makes lifestyle correction mandatory in all patients, with the potential not only to improve liver disease, but also hyperglycaemia, atherogenic dyslipidaemia and high blood pressure. Relatively small amounts of weight loss reduce liver fat and improve hepatic insulin resistance.
Bariatric surgery
Bariatric surgery is an efficient method to achieve significant weight loss, reverse insulin resistance, and reduce cardiovascular risk and long-term mortality. A meta-analysis on the effect of bariatric surgery in NAFLD revealed that the pooled proportion of patients with improvement or resolution was 91.6% for steatosis, 81.3% for steatohepatitis, 65.5% for fibrosis, and that 69.5% of patients experienced complete resolution of NASH. Nevertheless, the AASLD practice guidance states that while bariatric surgery can be considered in otherwise eligible patients with NAFLD or NASH, it is premature to consider it as an established option for the treatment of NASH.
Area
Suggested Intervention
Energy restriction
- 500 – 1000kcal energy defect
- 7 – 10% total weight loss target
- long-term maintenance approach
Alcohol intake
- strictly keep alcohol below the risk threshold
(30g, men, 20g, women)
- Moderate-intensity aerobic physical activities
(150 – 200 min/week) - 3-5 sessions
- Resistance training
PHARMACOTHERAPY: LACK OF APPROVED THERAPIES
European and U.S. guidelines recommend that pharmacotherapy should be reserved for patients with biopsy-proven NASH, particularly those with significant fibrosis (stage F2 and higher), but also those with early-stage NASH who are at high risk of disease progression. As yet, no drugs have been approved for treatment of NASH and thus any recommendation for pharmacological therapy is off label. However, the EASL-EASD-EASO guideline states that pioglitazone or vitamin E or their combination may be used for NASH.
RELATED Nash management ARTICLES
Improving NASH clinical trials: barriers and breakthroughs
Despite its global prevalence of 25%, no pharmacotherapies have yet been approved to treat non-alcoholic
Noninvasive tests for NAFLD: where are we now?
Up to 30% of patients with non-alcoholic fatty liver disease (NAFLD) progress to non-alcoholic steatohepatitis
Costs of Care for Non-Alcoholic Steatohepatitis in the United States: a Review
The rising healthcare costs of NASH highlight the need for early intervention. Higher FIB-4 scores
Non-Invasive Tests and Their Cut-Offs for Assessing Fibrosis: a Review
Heterogeneity in cut-off points for non-invasive fibrosis tests impacts NAFLD risk stratification. Standardized guidelines could
- Bower G, Toma T, Harling L, et al. Bariatric surgery and non-alcoholic fatty liver disease: a systematic review of liver biochemistry and histology. Obes Surg. 2015;25(12):2280-9.
- Budd J, Cusi K. Role of agents for the treatment of diabetes in the management of nonalcoholic fatty liver disease. Curr Diab Rep. 2020 Oct 5;20(11):59.
- Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. 2018;67(1):328-57.
- Dufour JF, Caussy C, Loomba R. Combination therapy for non-alcoholic steatohepatitis: rationale, opportunities and challenges. Gut. 2020 Oct;69(10):1877-1884
- European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016 Jun;64(6):1388-402.
- Mummadi RR, Kasturi KS, Chennareddygari S, Sood GK. Effect of bariatric surgery on nonalcoholic fatty liver disease: systematic review and meta-analysis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2008;6(12):1396-402
- Muthiah MD, Sanyal AJ. Current management of non-alcoholic steatohepatitis. Liver Int. 2020; 40(Suppl 1):89-95
- Younossi ZM, Corey KE, Lim JK. AGA clinical practice update on lifestyle modification using diet and exercise to achieve weight loss in the management of nonalcoholic fatty liver disease: expert review. Gastroenterology. 2021 Feb;160(3):912-918
Exploring Innovative NASH Therapies and Effective Management Strategies
As the prevalence of NASH continues to rise, it is essential for healthcare professionals to stay informed about the latest research, therapies, and management approaches. This page provides a comprehensive overview of the current state of NASH treatment, discussing the importance of lifestyle interventions and the ongoing development of new therapies. Dive deep into the evolving landscape of NASH management and discover the best practices to optimize patient outcomes in this increasingly common liver disease. Stay ahead of the curve and empower your practice with cutting-edge knowledge on NASH treatment strategies.
