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Adv Pharm Bull. 2020;10(4): 542-555.
doi: 10.34172/apb.2020.065
PMID: 33072533
PMCID: PMC7539311
Scopus ID: 85090431671
  Abstract View: 1624
  PDF Download: 1362
  Full Text View: 407

Review Article

The Evaluation of Effective Drugs for the Treatment of Non-Alcoholic Fatty Liver Disease: A Systematic Review and Network Meta-Analysis

Ramin Jalili 1 ORCID logo, Mohammad Hossein Somi 2, Hossein Hosseinifard 3, Fatemeh Salehnia 3, Morteza Ghojazadeh 3, Nima Makhdami 4, Masoud Shirmohammadi 5* ORCID logo

1 Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran.
4 St Joseph’s Hospital, Hamilton, Canada.
5 Department of Gastroenterology, Liver, and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
*Corresponding Author: *Corresponding Author: Masoud Shirmohammadi, Tel:+98 41 33373741, Fax:+98 41 33373741, Email: , Email: shirmohammadim@tbzmed.ac.ir

Abstract

Purpose: Non-alcoholic fatty liver disease (NAFLD) and steatohepatitis are two forms of fatty liver disease with benign and malignant nature, respectively. These two conditions can cause an increased risk of liver cirrhosis and hepatocellular carcinoma. Given the importance and high prevalence of NAFLD, it is necessary to investigate the results of different studies in related scope to provide a clarity guarantee of effectiveness. Therefore, this systematic review and meta-analysis aim to study the efficacy of various medications used in the treatment of NAFLD.

Methods: A systematic search of medical databases identified 1963 articles. After exclusion of duplicated articles and those which did not meet our inclusion criteria, eta-analysis was performed on 84 articles. Serum levels of alanine aminotransferase (ALT), aspartate amino transferase (AST) were set as primary outcomes and body mass index (BMI), hepatic steatosis, and NAFLD activity score (NAS) were determined as secondary outcomes.

Results: Based on the P-score of the therapeutic effects on the non-alcoholic steatohepatitis (NASH), we observed the highest efficacy for atorvastatin, tryptophan, orlistat, omega-3 and obeticholic acid for reduction of ALT, AST, BMI, steatosis and NAS respectively.

Conclusion: This meta-analysis showed that atorvastatin. life-style modification, weight loss, and BMI reduction had a remarkable effect on NAFLD-patients by decreasing aminotransferases.

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Submitted: 24 Oct 2019
Revision: 07 Jan 2020
Accepted: 27 Jan 2020
ePublished: 09 Aug 2020
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