Non-alcoholic Steatohepatitis: From Pathophysiology to Clinical Practice.

TouchREVIEWS in endocrinology Pub Date : 2021-11-01 Epub Date: 2021-09-14 DOI:10.17925/EE.2021.17.2.112
Sherwyn Schwartz, Jean Lucas, Mark H DeLegge
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Abstract

Non-alcoholic steatohepatitis (NASH) is becoming a global disease with significant associated comorbidities. To date, there are no commercialized drugs to treat NASH, outside of India; however, there is an abundance of new molecular entities which are in clinical development, some in phase III trials. Many of these trials have created an especially heavy demand for USA-based subjects. Hepatologists currently play a major role in the diagnosis, treatment and clinical-trial enrolment of patients with NASH. However, NASH has a strong metabolic component, with patients often carrying comorbid diseases, such as type 2 diabetes mellitus, obesity, hyperlipidaemia, hypothyroidism and sex steroid disorders. The primary care physician, internist and endocrinologist stand at a pivotal position in the NASH healthcare delivery system, as many of the diseases they commonly encounter are associated with a higher risk of developing NASH. Specialty society practice guidelines are evolving regarding the identification and care of patients with NASH. This review of the literature, and assessment of IQVIA's proprietary patient claims database of diagnosis codes, patient encounters and treatments, substantiates the importance of the primary care provider and endocrinologist in the clinical care and clinical research of patients with NASH.

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非酒精性脂肪性肝炎:从病理生理学到临床实践。
非酒精性脂肪性肝炎(NASH)正在成为一种具有显著相关合并症的全球性疾病。到目前为止,在印度以外,还没有商业化的治疗NASH的药物;然而,有大量新的分子实体正在临床开发中,其中一些正在进行III期试验。其中许多试验对美国受试者产生了特别大的需求。肝病学家目前在NASH患者的诊断、治疗和临床试验登记方面发挥着重要作用。然而,NASH具有很强的代谢成分,患者经常携带合并症,如2型糖尿病、肥胖、高脂血症、甲状腺功能减退和性类固醇疾病。初级保健医生、内科医生和内分泌学家在NASH医疗保健系统中处于关键地位,因为他们经常遇到的许多疾病都与患NASH的风险较高有关。关于NASH患者的识别和护理,专业协会的实践指南正在不断发展。这篇文献综述,以及对IQVIA专有的诊断代码、患者遭遇和治疗患者索赔数据库的评估,证实了初级保健提供者和内分泌学家在NASH患者的临床护理和临床研究中的重要性。
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