Abstract
Non-Alcoholic Fatty Liver Disease (NAFLD) is a highly prevalent disease and unmet
clinical need that we have recently proposed to be renamed for simplicity and accuracy
as Fatty Liver Disease (FLD), with specific subclassifications. It has been commonly
associated with metabolic comorbidities, including obesity, type 2 diabetes (T2D),
hypertension, and hyperlipidemia. Since no Federal and Drug Administration (FDA) approved
treatments exist to date, recent guidelines recommend lifestyle interventions, bariatric
surgery, and pharmacotherapy, i.e. glucagon-like peptide-1 receptor agonists (GLP-1RA),
peroxisome proliferator-activated receptor-γ (PPAR-γ) agonists, and SGLT-2 inhibitors
for its treatment. A new and novel medication for the treatment of T2D, tirzepatide,
a dual GIP/GLP-1RA, was approved by the FDA only one week after guidelines were published,
and ongoing clinical trials demonstrate promising results not only for T2D but also
for body weight and steatosis. Moreover, we realize that distinct subgroups exist
under the umbrella of FLD and, thus, more precise therapeutic recommendations would
be needed towards the goal of personalized medicine and therapeutics for these subgroups.
As the metabolism field is moving forward very fast and as several molecules in development
will most likely demonstrate benefits in NAFLD treatment in the foreseeable future,
guidelines will need to be frequently updated. This rapid pace of change prompts us
to propose that guidelines should exist as living online documents on the websites
of professional societies, so that they continue being updated following and reflecting
the rapid progress in this and other fields of medicine.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: July 04, 2022
Accepted:
June 22,
2022
Received:
June 16,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
