Treatment options for alcoholic and non-alcoholic fatty liver disease: A review

World J Gastroenterol. 2017 Sep 28;23(36):6549-6570. doi: 10.3748/wjg.v23.i36.6549.

Abstract

Alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) are serious health problems worldwide. These two diseases have similar pathological spectra, ranging from simple steatosis to hepatitis to cirrhosis and hepatocellular carcinoma. Although most people with excessive alcohol or calorie intake display abnormal fat accumulation in the liver (simple steatosis), a small percentage develops progressive liver disease. Despite extensive research on understanding the pathophysiology of both these diseases there are still no targeted therapies available. The treatment for ALD remains as it was 50 years ago: abstinence, nutritional support and corticosteroids (or pentoxifylline as an alternative if steroids are contraindicated). As for NAFLD, the treatment modality is mainly directed toward weight loss and co-morbidity management. Therefore, new pathophysiology directed therapies are urgently needed. However, the involvement of several inter-related pathways in the pathogenesis of these diseases suggests that a single therapeutic agent is unlikely to be an effective treatment strategy. Hence, a combination therapy towards multiple targets would eventually be required. In this review, we delineate the treatment options in ALD and NAFLD, including various new targeted therapies that are currently under investigation. We hope that soon we will be having an effective multi-therapeutic regimen for each disease.

Keywords: Alcoholic liver disease; Glucocorticoids; Liver transplantation; Non-alcoholic fatty liver disease; Treatment options.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Alcohol Abstinence*
  • Alcoholism / complications
  • Diet, Reducing*
  • Healthy Lifestyle
  • Humans
  • Liver / drug effects
  • Liver / pathology
  • Liver / surgery
  • Liver Diseases, Alcoholic / etiology
  • Liver Diseases, Alcoholic / mortality
  • Liver Diseases, Alcoholic / therapy*
  • Liver Transplantation*
  • Molecular Targeted Therapy / mortality
  • Non-alcoholic Fatty Liver Disease / etiology
  • Non-alcoholic Fatty Liver Disease / mortality
  • Non-alcoholic Fatty Liver Disease / therapy*
  • Nutritional Support / methods
  • Protective Agents / therapeutic use
  • Risk Factors
  • Stem Cell Transplantation
  • Treatment Outcome
  • Weight Loss

Substances

  • Adrenal Cortex Hormones
  • Protective Agents