The pleiotropic effects of glucagon-like peptide-1 receptor agonists in patients with metabolic dysfunction-associated steatohepatitis: a review for gastroenterologists
Expert Opinion on Investigational Drugs,
Год журнала:
2025,
Номер
unknown
Опубликована: Фев. 27, 2025
Glucagon-like
peptide-1
receptor
agonists
(GLP-1RAs),
and
dual
GLP-1/glucose-dependent
insulinotropic
peptide
(GIP)
or
glucagon
have
emerged
as
promising
agents
to
treat
metabolic
dysfunction-associated
steatotic
liver
disease
(MASLD)/metabolic
steatohepatitis
(MASH).
Although
the
beneficial
effects
of
GLP-1RAs
on
glycemic
control
weight
are
well-established,
clinicians
may
be
unfamiliar
with
other
potential
benefits
this
class.
We
examined
pleiotropic
how
they
relate
gastroenterologists
for
MASLD/MASH
treatment.
Our
narrative
review
English
articles
included
four
(subcutaneous
semaglutide,
liraglutide,
dulaglutide,
efpeglenatide),
a
GLP-1/GIP
agonist
(tirzepatide),
GLP-1/glucagon
(survodutide),
MASLD/MASH,
related
disorders,
clinical
management,
treatment
outcomes
landscape.
In
Phase
I
-
III
trials,
associated
clinically
relevant
hepatic
improvements
including
MASH
resolution,
fat
reduction,
preventing
worsening
fibrosis.
Effects
cardiometabolic
parameters
align
type
2
diabetes/obesity
data,
comprising
substantial
in
glycemic,
weight,
cardiovascular
outcomes.
Promising
data
also
suggest
common
comorbidities,
obstructive
sleep
apnea,
polycystic
ovary
syndrome,
chronic
kidney
disease,
heart
failure
preserved
ejection
fraction.GLP-1RAs
represent
valuable
pharmacotherapeutic
option
managing
individuals
comorbid
conditions.
Язык: Английский
Budget impact of resmetirom for the treatment of adults with non-cirrhotic non-alcoholic steatohepatitis (NASH) with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis)
Journal of Medical Economics,
Год журнала:
2024,
Номер
27(1), С. 1108 - 1118
Опубликована: Авг. 19, 2024
Aims
This
study
assessed
the
budget
impact
of
resmetirom
as
a
treatment
for
adults
with
non-cirrhotic
non-alcoholic
steatohepatitis
(NASH)
moderate-to-advanced
liver
fibrosis
and
estimated
total
costs
hypothetical
private
payer
in
United
States.
Язык: Английский
Survival and Cost-Effectiveness of Bariatric Surgery Among Patients With Obesity and Cirrhosis
JAMA Surgery,
Год журнала:
2025,
Номер
unknown
Опубликована: Апрель 2, 2025
Obesity
and
steatotic
liver
disease
are
associated
with
excess
morbidity
mortality
from
cardiovascular,
pulmonary,
metabolic,
hepatic
causes.
Bariatric
surgery
has
demonstrated
long-term
benefits
in
terms
of
weight
loss
rates,
but
barriers
to
its
utilization
persist.
To
evaluate
the
impact
bariatric
on
outcomes
cost-effectiveness
among
patients
obesity,
focusing
those
cirrhosis.
This
economic
evaluation
was
a
retrospective
cohort
study
including
US
veterans
older
than
18
years
body
mass
index
(BMI)
higher
35
or
BMI
30
more
1
major
metabolic
comorbidity.
These
were
referred
structured
lifestyle
modification
program
(MOVE!),
subset
proceeded
surgery,
sleeve
gastrectomy
(SG)
Roux-en-Y
gastric
bypass
(RYGB)
2008
2020.
Risk
set
matching
used
match
cases
1:5
nonsurgical
controls.
Data
analyzed
September
2023.
(SG
RYGB)
intervention
(MOVE!).
The
primary
incremental
ratio
(ICER)
SG
RYGB
vs
MOVE!
over
10
years.
Secondary
included
overall
survival,
quality-adjusted
achieved.
final
4301
SG,
1906
RYGB,
31
055
participants,
whom
64,
8,
354,
respectively,
had
median
(IQR)
age
52
(44-59)
years;
there
25
581
male
(68.7%)
11
681
female
(31.3%).
Compared
MOVE!,
longer
observed
survival
(9.67
9.46
overall;
9.09
8.23
cirrhosis).
ICER
$132
207
for
$159
027
cohort,
$18
679
$44
704
cirrhosis
cohorts.
cost-effective
at
willingness-to-pay
threshold
$100
000
per
life-year
improved
expected
cost-effective.
findings
support
expanded
use
appropriately
selected
patients,
cirrhosis,
improve
reduce
health
care
costs.
Язык: Английский
Clinical Insights on Resmetirom
Journal of Clinical Gastroenterology,
Год журнала:
2025,
Номер
59(5), С. 412 - 419
Опубликована: Фев. 13, 2025
The
recent
conditional
approval
by
the
Food
and
Drug
Administration
of
resmetirom
for
treating
metabolic
dysfunction-associated
steatohepatitis
(MASH)
with
significant
or
advanced
fibrosis
represents
a
pivotal
milestone
in
history
steatotic
liver
disease
(MASLD)
treatment.
As
first
liver-directed
pharmacological
therapy
option
MASLD,
offers
novel
approach
that
specifically
targets
pathology,
marking
transformative
step
forward
managing
this
widespread
challenging
condition.
For
initiating
resmetirom,
biopsy
is
not
required.
Consequently,
accurately
excluding
patients
less
severe
histology
cirrhosis
using
noninvasive
tests
(NITs)
essential.
In
addition,
monitoring
response
should
be
conducted
NITs.
Given
approval,
our
current
clinical
understanding
primarily
informed
phase
3
trials.
long-term
effects
drug
evaluated
further
studies
encouraging
use
eligible
patients.
This
review
highlights
key
aspects
use,
including
identifying
target
population,
therapeutic
response,
determining
appropriate
discontinuation
criteria,
strategies
to
prevent
unnecessary
treatment
interruptions.
Язык: Английский
Estimating the clinical and healthcare burden of metabolic dysfunction-associated steatohepatitis in England: a retrospective cohort study using routinely collected healthcare data from 2011 to 2020
BMJ Open,
Год журнала:
2025,
Номер
15(4), С. e095761 - e095761
Опубликована: Апрель 1, 2025
Objective
To
characterise
patients
with
metabolic
dysfunction-associated
steatohepatitis
(MASH)
in
England
and
to
estimate
its
associated
healthcare
resource
use
(HCRU)
costs,
both
overall
by
progression
status
comorbidities.
Design
This
was
a
retrospective
observational
study
of
adults
MASH-coded
primary
and/or
secondary
care
recorded
diagnosis
(2011–2020).
The
analysis
used
data
from
the
Clinical
Practice
Research
Datalink
linked
Hospital
Episode
Statistics
death
registrations.
Annualised
all-cause
MASH-related
(ie,
coded
as
MASH,
end-stage
liver
disease
or
major
adverse
cardiovascular
event)
HCRU
costs
were
calculated
for
incident
MASH.
Subgroup
analyses
conducted
type
2
diabetes,
overweight/obesity,
cirrhosis.
Comparative
cost
between
those
progressed
MASH
who
did
not
progress.
Results
A
total
2696
included
(mean
follow-up:
4
years).
Incidence
estimated
at
4.7
per
100
000
person-years
increased
among
key
Patients
had
diabetes
greater
than
(eg,
mean
1.8
vs
1.0
inpatient
admissions
£2227
£1151
per-patient
per-year).
Some
compensated
(8.6%)
decompensated
cirrhosis
(6.5%)
during
study.
substantially
higher
2.4
1.1
£3620
£1290
Conclusion
are
have
cardiometabolic
comorbidities
progress
advanced
stages.
Therefore,
efforts
detect
cases
early
prevent
could
reduce
burden.
Язык: Английский
Estimation of the Eligible Population For Resmetirom Among Adults in the United States for Treatment of Non-Cirrhotic NASH with Moderate-to-Advanced Liver Fibrosis
Advances in Therapy,
Год журнала:
2024,
Номер
41(11), С. 4172 - 4190
Опубликована: Сен. 18, 2024
As
of
March
2024,
resmetirom
is
the
first
and
only
therapy
approved
in
United
States
(US)
for
treatment
adults
with
non-cirrhotic
nonalcoholic
steatohepatitis
(NASH)
moderate-to-advanced
liver
fibrosis
(MALF)
consistent
stages
F2/F3
fibrosis.
Estimates
diagnosed,
treatment-eligible
NASH
population
are
poorly
understood
due
to
diagnostic
variability.
This
study
provides
a
contemporary
estimate
size
US
population.
Язык: Английский
Progression from Non-alcoholic Steatohepatitis to Advanced Liver Diseases and Mortality Among Medicare Patients
Advances in Therapy,
Год журнала:
2024,
Номер
41(11), С. 4335 - 4355
Опубликована: Сен. 24, 2024
Non-alcoholic
steatohepatitis
(NASH)
may
progress
to
more
advanced
liver
disease.
This
study
aimed
characterize
NASH
progression
and
mortality
in
the
Medicare
population.
Язык: Английский
Artificial Intelligence in Identifying Patients With Undiagnosed Nonalcoholic Steatohepatitis
Journal of health economics and outcomes research,
Год журнала:
2024,
Номер
11(2)
Опубликована: Сен. 25, 2024
Background:
Although
increasing
in
prevalence,
nonalcoholic
steatohepatitis
(NASH)
is
often
undiagnosed
clinical
practice.
Objective:
This
study
identified
patients
the
Veterans
Affairs
(VA)
health
system
who
likely
had
NASH
using
a
machine
learning
algorithm.
Methods:
From
VA
data
set
of
25
million
adult
enrollees,
population
was
divided
into
NASH-positive,
non-NASH,
and
at-risk
cohorts.
We
performed
claims
analysis
To
build
our
model,
randomly
an
80%
training
subset
20%
testing
tested
trained
cross-validation
technique.
In
addition
to
baseline
gradient-boosted
classification
tree,
naïve
Bayes,
random
forest
model
were
created
compared
receiver
operator
characteristics,
area
under
curve,
accuracy.
The
best
performing
retrained
on
full
applied
calculate
performance
metrics.
Results:
total,
4
223
443
met
inclusion
criteria,
whom
4903
positive
for
35
528
non-NASH
patients.
remainder
patient
cohort,
which
514
997
(12%)
as
have
NASH.
Age,
obesity,
abnormal
liver
function
tests
top
determinants
assigning
probability.
Conclusions:
Utilization
predict
allows
wider
recognition,
timely
intervention,
targeted
treatments
improve
or
mitigate
disease
progression
could
be
used
initial
screening
tool.
Язык: Английский
Costs associated with nonalcoholic steatohepatitis disease progression in Medicare patients: a retrospective cohort study
Journal of Comparative Effectiveness Research,
Год журнала:
2024,
Номер
unknown
Опубликована: Ноя. 22, 2024
Aim:
Non-alcoholic
steatohepatitis
(NASH),
or
metabolic
dysfunction-associated
(MASH),
is
a
severe
form
of
non-alcoholic
fatty
liver
disease
(NAFLD)
(MASLD),
that
may
progress
to
advanced
disease.
Costs
associated
with
progression
are
not
well
characterized.
This
study
sought
quantify
costs
and
healthcare
resource
utilization
(HRU)
NASH
progression.
Methods:
Patients
were
included
if
diagnosed
(ICD-10:
K75.81)
in
100%
Medicare
claims
data
(2015–2021)
who
≥66
years
at
index
(diagnosis),
continuously
enrolled
Parts
A,
B
D
for
≥12
months
prior
6
following
(unless
death)
had
no
evidence
other
causes
Patient-time
was
categorized
into
five
severity
states:
non-cirrhotic
NASH,
compensated
cirrhosis
(CC),
decompensated
(DCC),
hepatocellular
carcinoma
(HCC)
transplant
(LT).
Annualized
HRU
calculated
during
the
periods
overall
stratified
by
occurrence
timing
Results:
In
14,806
unique
patients
(n
=
12,990
NASH;
1899
CC;
997
DCC;
209
HCC;
140
LT),
mean
age
follow-up
72.2
2.8
years,
respectively.
Average
annualized
increased
from
baseline
diagnosis,
generally
scaling
severity:
$16,231
$27,044;
$25,122
$57,705;
$40,613
$181,036;
$36,549
$165,121
$35,626
$108,918
LT;
Non-cirrhotic
CC
higher
spending
(1.6x
1.7x
CC)
than
non-progressors
(both
p
<
0.001),
6.1-times
odds
an
inpatient
stay
2.6
3.6-times
be
top
20%
spenders,
respectively,
relative
0.001).
progressing
within
year
1.4,
1.6,
1.7
2.2-times
more
2,
3,
4
5
progressors'
costs,
1.3,
1.8,
2.0
CC.
Conclusion:
high
increase
states.
Slower
lower
suggesting
potential
benefit
therapies
delay
prevent
Язык: Английский