■非酒精性脂肪性肝病(NAFLD),从非酒精性脂肪性肝炎(NASH)到肝纤维化,在肥胖和代谢综合征发病率上升的情况下,构成了全球健康挑战。NASH和肝纤维化的有效药物治疗是有限的。
■本研究系统回顾和荟萃分析了瑞美特罗姆的安全性和有效性,选择性甲状腺激素受体-β激动剂,在NASH和肝纤维化治疗中。通过分析临床试验的数据,我们的目标是为resmetirom在管理这些疾病中的使用提供循证建议,并确定未来研究的途径。
■电子数据库(PubMed,Scopus,科学直接,谷歌学者,ClinicalTrials.gov,和CochraneCENTRAL)进行了系统搜索,辅以相关来源的人工筛选。仅包括英语随机对照试验。数据提取,偏见风险评估,汇集分析,并进行meta回归。
■对涉及2231名参与者的三项随机对照试验进行了分析。Resmetrom显示肝脏脂肪分数显着降低[标准化平均差(SMD)-4.61,95%CI-6.77至-2.44,P<0.0001],无纤维化恶化的NASH消退[风险比(RR)2.51,95%CI1.74-3.64,P=0.00001),和肝纤维化改善(RR2.31,95%CI1.20-4.44,P=0.01)。次要结果显示血脂状况显著改善,肝酶,和Resmetirom治疗的NASH生物标志物。Meta回归揭示了协变量与主要结局之间的关联。
■Resmetirom在减少肝脏脂肪方面表现出很有希望的功效,提高NASH分辨率,并改善肝纤维化,具有良好的安全性。需要进一步的研究以验证NASH和肝纤维化管理的发现并优化治疗策略。
UNASSIGNED: Non-alcoholic fatty liver disease (NAFLD), spanning from non-alcoholic steatohepatitis (NASH) to liver fibrosis, poses a global health challenge amid rising obesity and metabolic syndrome rates. Effective pharmacological treatments for NASH and liver fibrosis are limited.
UNASSIGNED: This study systematically reviews and meta-analyzes the safety and efficacy of resmetirom, a selective thyroid hormone receptor-β agonist, in NASH and liver fibrosis treatment. By analyzing data from clinical trials, we aim to offer evidence-based recommendations for resmetirom\'s use in managing these conditions and identify avenues for future research.
UNASSIGNED: Electronic databases (PubMed, Scopus, Science Direct, Google Scholar, ClinicalTrials.gov, and Cochrane CENTRAL) were systematically searched, supplemented by manual screening of relevant sources. Only English-language randomized controlled trials were included. Data extraction, risk of bias assessment, pooled analyses, and meta-regression were performed.
UNASSIGNED: Three randomized controlled trials involving 2231 participants were analyzed. Resmetirom demonstrated significant reductions in hepatic fat fraction [standardized mean difference (SMD) -4.61, 95% CI -6.77 to -2.44, P < 0.0001], NASH resolution without worsening fibrosis [risk ratio (RR) 2.51, 95% CI 1.74-3.64, P = 0.00001), and liver fibrosis improvement (RR 2.31, 95% CI 1.20-4.44, P = 0.01). Secondary outcomes showed significant improvements in lipid profiles, liver enzymes, and NASH biomarkers with resmetirom treatment. Meta-regression revealed associations between covariates and primary outcomes.
UNASSIGNED: Resmetirom exhibits promising efficacy in reducing hepatic fat, improving NASH resolution, and ameliorating liver fibrosis with a favorable safety profile. Further research is warranted to validate findings and optimize therapeutic strategies for NASH and liver fibrosis management.