Effects of UDCA in Treatment of NAFLD – Clinical Review

Effects of UDCA in treatment of NFLD

<h2 id="introduction">Introduction</h2><ul><li>Non-alcoholic fatty liver disease (NAFLD) is the most common cause of diffuse chronic liver disease, worldwide.</li><li>NAFLD is expected to become the most common clinical form of the chronic liver disease<br>progressing to end-stage cirrhosis and hepatocellular carcinoma (HCC), consequently becoming the main indication for liver transplantation.</li><li>Several researchers have examined the effects of ursodeoxycholic acid (UDCA) on non-alcoholic liver disease, over the past few years.</li><li>This review presents the key studies that investigated the pathogenic mechanisms and the beneficial impact of ursodeoxycholic acid (UDCA) treatment among patients with NAFLD.</li></ul><h2 id="materials-and-methods">Material &amp; Methods</h2><ul><li>30 articles contributed to the creation of this review.</li><li>This systematic review was conducted and reported according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA).</li><li>Several studies have been conducted to highlight the beneficial impact of UDCA in patients with NAFLD. The results and effects of UDCA treatment in patients with NAFLD are shown in table 1.</li></ul><p style="text-align:center;">Table 1. Summary of included studies.</p><figure class="image"><img style="aspect-ratio:1036/597;" src="https://cdn.megawecare.com/GHBY/Internal-Images/summary-of-patient-study.webp" width="1036" height="597"></figure><figure class="image"><img style="aspect-ratio:1294/1851;" src="https://cdn.megawecare.com/GHBY/Internal-Images/summary-of-patient-study-2.webp" width="1294" height="1851"></figure><h2 id="effects">Effects of UDCA Treatment on NAFLD</h2><ul><li>Vitamin E and Pioglitazone are considered first-line drugs due to their beneficial impact on serum transaminases, inflammation, and lipid accumulation. However, it is important to note that vitamin E has no effects on fibrosis and long-term mortality and morbidity, and Pioglitazone has negative effects on weight.</li><li>Pathogenesis of steatohepatitis is complex, hence the association of several products that act in different stages of pathogenesis has been proposed, requiring comprehensive studies with long-term results.</li><li>In recent decades, UDCA has been of interest for the treatment of NAFLD patients due to its hepatoprotective effects.</li><li>UDCA intervenes in the process of hepatocytic apoptosis, which is a characteristic of patients with NASH, but also reduces the serum level of Tumor necrosis factor-a (TNF-a), which is increased in these patients and aggravates insulin resistance (IR). Due to these beneficial effects, the use of UDCA in these patients has numerous benefits on disease progression.</li><li>Monotherapy significantly improves liver function by improving alanine aminotransferase;<br>aspartate aminotransferase; gamma glutamyltransferase (ALT,AST,GGT} levels, and also reduces the degree of steatosis and fibrosis.</li></ul><h2 id="conclusion">Conclusion</h2><ul><li>This review study concludes that UDCA has proven to be beneficial in the treatment of steatohepatitis, particularly when used in conjunction with other medications.</li><li>Ursodeoxycholic acid (UDCA), has been one of the most studied agents in the last decades which is of great interest in the treatment of NAFLD due to its hepatoprotective effects.</li></ul>

GASTRO UPDATES 2024 ISSUE 3

<ul><li><a href="#introduction">Introduction</a></li><li><a href="#materials-and-methods">Material &amp; Methods</a></li><li><a href="#effects">Effects of UDCA Treatment on NAFLD</a></li><li><a href="#conclusion">Conclusion</a></li></ul>