■代谢功能障碍相关的脂肪性肝病(MASLD)和代谢功能障碍相关的脂肪性肝炎(MASH)是与肥胖和代谢紊乱有关的流行病症。有潜在的并发症,如肝硬化和心血管风险。本系统评价和荟萃分析旨在评估匹马贝特的疗效,一种针对脂肪和糖代谢基因的药物,用MASLD/MASH治疗患者。
■MEDLINE等数据库,WebofScience,科克伦图书馆,和Scopus被搜索到2023年9月,以确定相关研究。选定的研究使用风险偏差2工具(ROB-2)和美国国立卫生研究院(NIH)质量评估工具等工具进行了全面的质量评估。综合荟萃分析软件用于统计评价,专注于脂质分布,肝功能检查,和纤维化测量。
■共纳入13项研究;其中10项纳入定量分析。我们的发现表明,匹马贝特显着降低低密度脂蛋白胆固醇(LDL-C)(效应大小(ES)=-9.61mg/dL,95%置信区间(CI):-14.15至-5.08),高密度脂蛋白胆固醇(HDL-C)升高(ES=3.15mg/dL,95%CI:1.53至4.78),和降低的甘油三酯(TG)(ES=-85.98mg/dL,95%CI:-96.61至-75.36)。此外,培马贝特显示肝酶水平显著降低,包括天冬氨酸氨基转移酶(AST),丙氨酸氨基转移酶(ALT),γ-谷氨酰转肽酶(GGT),和碱性磷酸酶(ALP),具有显著的效应大小和P值。对于肝脏硬度结果,培马贝特降低AST与血小板比率指数(APRI)(ES=-0.180,95%CI:-0.221至-0.138)。
■培巴贝特,凭借其增强的功效和安全性,作为MASLD/MASH治疗的关键药物。它的调脂特性,加上它对肝脏炎症标志物的有益作用,将其定位为潜在的无价治疗选择。
UNASSIGNED: Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are prevalent conditions linked to obesity and metabolic disturbances, with potential complications such as cirrhosis and cardiovascular risks. This systematic review and meta-analysis aimed to evaluate the efficacy of
pemafibrate, a drug targeting fat and sugar metabolism genes, in treating patients with MASLD/MASH.
UNASSIGNED: Databases such as MEDLINE, Web of Science, Cochrane Library, and Scopus were searched until September 2023 to identify relevant studies. Selected studies underwent a thorough quality assessment using tools like Risk of Bias 2 tool (ROB-2) and the National Institutes of Health (NIH) Quality Assessment Tools. Comprehensive meta-analysis software was used for statistical evaluations, with a focus on lipid profiles, liver function tests, and fibrosis measurements.
UNASSIGNED: A total of 13 studies were included; 10 of them were included in the quantitative analysis. Our findings showed that
pemafibrate significantly decreased low-density lipoprotein cholesterol (LDL-C) (effect size (ES) = -9.61 mg/dL, 95% confidence interval (CI): -14.15 to -5.08), increased high-density lipoprotein cholesterol (HDL-C) (ES = 3.15 mg/dL, 95% CI: 1.53 to 4.78), and reduced triglycerides (TG) (ES = -85.98 mg/dL, 95% CI: -96.61 to -75.36). Additionally,
pemafibrate showed a marked reduction in liver enzyme levels, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP), with significant effect sizes and P values. For liver stiffness outcomes,
pemafibrate decreased AST to platelet ratio index (APRI) (ES = -0.180, 95% CI: -0.221 to -0.138).
UNASSIGNED: Pemafibrate, with its enhanced efficacy and safety profile, presents as a pivotal agent in MASLD/MASH treatment. Its lipid-regulating properties, coupled with its beneficial effects on liver inflammation markers, position it as a potentially invaluable therapeutic option.