雷美替罗与代谢功能障碍相关性脂肪性肝炎:来自全球医疗保健专业人士的多学科管理视角。

IF 9.5 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Current Obesity Reports Pub Date : 2024-12-01 Epub Date: 2024-08-07 DOI:10.1007/s13679-024-00582-z
Kahei Au, Ming-Hua Zheng, Wei-Jei Lee, Omar M Ghanem, Kamal Mahawar, Asim Shabbir, Carel W le Roux, Giovanni Targher, Christopher D Byrne, Yusuf Yilmaz, Luca Valenti, Giada Sebastiani, Sombat Treeprasertsuk, Hannah Xiaoyan Hui, Nasser Sakran, Manoel Galvao Neto, Mohammad Kermansaravi, Lilian Kow, Yosuke Seki, Kwang Wei Tham, Jerry Dang, Ricardo V Cohen, Christine Stier, Salman AlSabah, Rodolfo J Oviedo, Sonja Chiappetta, Chetan Parmar, Wah Yang
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引用次数: 0

摘要

审查目的:瑞美替罗的批准为代谢功能障碍相关性脂肪性肝炎(MASH)患者带来了巨大希望。本综述旨在探讨其对全球健康环境的影响。建议实施多学科管理 MASH:Resmetirom 可用于治疗 MASH,其安全性和有效性已得到研究。不良事件(AEs)需要引起注意。为改善患者预后,可采用瑞美替罗等药物治疗结合代谢与减肥手术(MBS)和生活方式干预的多模式方法。MASH是一种与肥胖有关的肝脏疾病,由于没有任何获批的药物疗法,它成为全球医疗保健领域的一大难题。美国食品和药物管理局(FDA)最近有条件批准了一种口服、肝脏导向性甲状腺激素受体β选择性激动剂resmetirom,这是一个重要的里程碑,为患有非肝硬化MASH且肝纤维化程度为中晚期的成人患者提供了一种治疗选择。这篇叙述性综述讨论了雷美替罗的疗效和安全性及其在MASH治疗中的作用。尽管瑞美替罗对肝脏组织学终点具有良好的保肝作用,但其使用仍需进一步研究,尤其是在种族差异、有效性和成本效益、生产可扩展性、社会接受度和可及性方面。此外,将瑞美替罗与其他多学科治疗方法(包括改变生活方式和MBS)相结合,可能会进一步改善MASH患者的临床肝脏相关结果和心脏代谢结果。本综述强调了综合治疗策略的重要性,支持持续创新和合作研究,以完善治疗指南和达成管理MASH的共识,从而在MASH全球流行病日益增多的情况下改善患者的临床治疗效果。迄今为止所做的研究时间相对较短且仍在进行中,该疾病的病程变化很大,不同患者的病情各不相同,鉴于这种复杂的临床表型,可能需要多年的临床试验才能显示出长期疗效。
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Resmetirom and Metabolic Dysfunction-Associated Steatohepatitis: Perspectives on Multidisciplinary Management from Global Healthcare Professionals.

Purpose of review: The approval of resmetirom brings great hope to patients with metabolic dysfunction-associated steatohepatitis (MASH). The purpose of this review is to explore its impact on the global health environment. The implementation of multidisciplinary management MASH is proposed.

Recent findings: Resmetirom has benefits in the treatment of MASH, and its safety and effectiveness have been studied. The adverse events (AEs) need to be noticed. To improve patient outcomes, a multimodal approach with medication such as resmetirom, combined with metabolic and bariatric surgery (MBS) and lifestyle interventions can be conducted. MASH, a liver disease linked with obesity, is a challenging global healthcare burden compounded by the absence of any approved pharmacotherapy. The recent conditional approval by the Food and Drug Administration (FDA) in the United States of resmetirom, an oral, liver-directed, thyroid hormone receptor beta-selective agonist, marks a significant milestone, offering a treatment option for adults with non-cirrhotic MASH and who have moderate to advanced liver fibrosis. This narrative review discusses the efficacy and safety of resmetirom and its role in the therapeutic landscape of MASH treatment. Despite the promising hepatoprotective effect of resmetirom on histological liver endpoints, its use need further research, particularly regarding ethnic differences, effectiveness and cost-effectiveness, production scalability, social acceptance and accessibility. In addition, integrating resmetirom with other multidisciplinary therapeutic approaches, including lifestyle changes and MBS, might further improve clinical liver-related and cardiometabolic outcomes of individuals with MASH. This review highlights the importance of a comprehensive treatment strategy, supporting continued innovation and collaborative research to refine treatment guidelines and consensus for managing MASH, thereby improving clinical patient outcomes in the growing global epidemic of MASH. Studies done to date have been relatively short and ongoing, the course of the disease is highly variable, the conditions of various patients vary, and given this complex clinical phenotype, it may take many years of clinical trials to show long-term benefits.

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来源期刊
Current Obesity Reports
Current Obesity Reports Medicine-General Medicine
CiteScore
16.40
自引率
1.10%
发文量
25
期刊介绍: The main objective of Current Obesity Reports is to provide expert review articles on recent advancements in the interdisciplinary field of obesity research. Our aim is to offer clear, insightful, and balanced contributions that will benefit all individuals involved in the treatment and prevention of obesity, as well as related conditions such as cardiovascular diseases, endocrine disorders, gynecological issues, cancer, mental health, respiratory complications, and rheumatological diseases. We strive to redefine the way knowledge is expressed and provide organized content for the benefit of our readership.
期刊最新文献
Correction: Beyond Obesity and Overweight: the Clinical Assessment and Treatment of Excess Body Fat In Children. Correction: Strengths and Limitations of BMI in the Diagnosis of Obesity: What is the Path Forward? The Role of Physical Exercise as a Therapeutic Tool to Improve Lipedema: A Consensus Statement from the Italian Society of Motor and Sports Sciences (Società Italiana di Scienze Motorie e Sportive, SISMeS) and the Italian Society of Phlebology (Società Italiana di Flebologia, SIF). Resmetirom and Metabolic Dysfunction-Associated Steatohepatitis: Perspectives on Multidisciplinary Management from Global Healthcare Professionals. The Kidney in Obesity: Current Evidence, Perspectives and Controversies.
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