Critical need for pharmacologic treatment options in NAFLD: A pediatric perspective

Friesen, Craig A.; Chan, Sherwin S; Wagner, Jon; Hosey-Cojocari, Chelsea; Csanaky, Iván L.; Shakhnovich, Valentina

doi:10.1111/cts.12952

Cited by 4 publications

(6 citation statements)

References 12 publications

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“…UTA Peñaloza O, Guevara L, Chiliquinga M, Tubón J, Maza D. Fallo hepático aguda en edad pediátrica, reporte de un caso. MEDICIENCIAS UTA.2024;8 (2):94-101. infecciosas, entre las cuales el virus de la hepatitis A (VHA) es el más común (5). Dentro de las pruebas a solicitar en este tipo de paciente están pruebas específicas del hígado: para evaluar el grado de inflamación, lesión y función y guiar las decisiones de trasplante.…”

Section: Tabla 2 Etiología Del Fallo Hepático Agudo Pediátrico (*Etio...unclassified

“…Además, se ha pensado que el análisis histopatológico tiene un valor limitado para determinar la estrategia de tratamiento o establecer el diagnóstico. Sin embargo, las biopsias hepáticas se realizan cada vez más mediante el abordaje transvenoso porque esta técnica reduce notablemente los riesgos de hemorragia en esta población (5).…”

Section: Tabla 2 Etiología Del Fallo Hepático Agudo Pediátrico (*Etio...unclassified

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Acute liver failure in pediatric age, case report

Peñaloza Ortiz,

Guevara Parra,

Chiliquinga Cando

et al. 2024

MedicienciasUTA

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Presentamos el caso clínico de un paciente pediátrico de 7 años de edad que acude al servicio de Emergencia con un cuadro de 15 días de evolución de ictericia acompañado de vómito, dolor en hipocondrio derecho, coluria, acolia, trae consigo resultados de exámenes de laboratorio realizados anteriormente donde reporta neutrofilia sin leucocitosis, función hepática alterada bilirrubina total 31, bilirrubina directa de 17.6, TGO 620, TGP 17, niega ingesta de fármacos o productos herbolarios, no viajes reciente, a la exploración física una hepatomegalia considerable enfrentándonos a un diagnóstico presuntivo a su ingreso de hiperbilirrubinemia por lo que se complementa exámenes como tiempos de coagulación prolongados, fosfatasa alcalina, gama GT y glucosa elevados se añade serología VDRL, VIH, TORCH, HEPATITIS B siendo negativo se complementa con estudio ecográfico de abdomen donde lo positivo hepato-esplenomegalia, colecistitis aguda reactiva más cambios sugerentes de inflamación de la glándula pancreática. Dando un giro a nuestro diagnóstico y cambiándolo a fallo hepático grave por lo que se dan medidas terapéuticas de soporte e iniciar transferencia a tercer nivel de salud para manejo integral. La insuficiencia hepática aguda pediátrica se caracteriza por la presencia de daño hepático, coagulopatía, ictericia y encefalopatía, en niños es poco común, pero con desenlace fatal hasta en un 70%. El diagnóstico se basa en exámenes de función hepática, además de biopsia percutánea para determinar la etiología. El tratamiento requiere un equipo multidisciplinario que incluya al hepatólogo, al especialista en cuidados intensivos, y al cirujano pediátrico

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Section: Tabla 2 Etiología Del Fallo Hepático Agudo Pediátrico (*Etio...unclassified

Acute liver failure in pediatric age, case report

Peñaloza Ortiz,

Guevara Parra,

Chiliquinga Cando

et al. 2024

MedicienciasUTA

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“…However, the landscape of potential therapeutic agents for NAFLD is evolving rapidly and showing promise, as highlighted in recently published reviews (26,46) beyond the scope of this publication. In addition to novel therapeutic agents (e.g., obeticholic acid, fibroblast growth factor 19 & 21 analogs, thyroid hormone receptor-b agonists), there is also interest in repurposing existing drugs-already approved for pediatric obesity or obesity comorbidities-for the treatment of pediatric NAFLD (47).…”

Section: Pharmacotherapy For Nafldmentioning

confidence: 99%

Efficacy of Weight Reduction on Pediatric Nonalcoholic Fatty Liver Disease: Opportunities to Improve Treatment Outcomes Through Pharmacotherapy

et al. 2021

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Obesity is the single greatest risk factor for nonalcoholic fatty liver disease (NAFLD). Without intervention, most pediatric patients with NAFLD continue to gain excessive weight, making early, effective weight loss intervention key for disease treatment and prevention of NAFLD progression. Unfortunately, outside of a closely monitored research setting, which is not representative of the real world, lifestyle modification success for weight loss in children is low. Bariatric surgery, though effective, is invasive and can worsen NAFLD postoperatively. Thus, there is an evolving and underutilized role for pharmacotherapy in children, both for weight reduction and NAFLD management. In this perspective article, we provide an overview of the efficacy of weight reduction on pediatric NAFLD treatment, discuss the pros and cons of currently approved pharmacotherapy options, as well as drugs commonly used off-label for weight reduction in children and adolescents. We also highlight gaps in, and opportunities for, streamlining obesity trials to include NAFLD assessment as a valuable, secondary, therapeutic outcome measure, which may aid drug repurposing. Finally, we describe the already available, and emerging, minimally-invasive biomarkers of NAFLD that could offer a safe and convenient alternative to liver biopsy in pediatric obesity and NAFLD trials.

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“…Early, effective intervention is critical to prevent disease progression into adulthood. Nevertheless, it is not often achieved through lifestyle modification alone [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Non-alcoholic Fatty Liver in Children and Adolescents in Saudi Arabia

Mujlli,

Mahzari,

Alslamah

et al. 2023

Cureus

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Objectives This study aims to describe the disease parameters of children and adolescents diagnosed with non-alcoholic fatty liver disease (NAFLD) in Saudi Arabia. It also investigates the disease's progression and compares clinical, biochemical, and radiological parameters at baseline and follow-up of patients with NAFLD. This study was done between two groups of patients: obese and those of average body weight. Methods A retrospective cohort study was conducted between 2014 and 2018 through retrieved data from medical records. It included all children aged between six to 18 years diagnosed with NAFLD. Medical history was taken from each medical record, liver function test results, cholesterol, blood pressure readings, and body weight. Data have been restored from King Abdullah Specialist Children's Hospital (KASCH), Security Forces Hospital (SFH), and King Khalid University Hospital (KKUH) . Results A total of 116 subjects met the inclusion criteria; 65 (56%) were male, and 81 (70%) were obese. The majority of subjects (n=112) had mild NAFLD, with (71%) obese and (29%) non-obese, followed by moderate NAFLD with 50% among obese and non-obese (N=2), and non-alcoholic steatohepatitis (NASH) with 100% non-obese (N=2). Data showed that patients' proportion of obese to non-obese is 70% (N=81) to 30% (N=35), respectively. Conclusion NAFLD was found to affect obese children and adolescents more than non-obese, and male patients had a higher proportion of NAFLD than females. Also, obese patients had more advanced stages of NAFLD than non-obese patients. Finally, most subjects had been diagnosed with mild stage while a few had developed NASH.

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Critical need for pharmacologic treatment options in NAFLD: A pediatric perspective

Cited by 4 publications

References 12 publications

Acute liver failure in pediatric age, case report

Acute liver failure in pediatric age, case report

Efficacy of Weight Reduction on Pediatric Nonalcoholic Fatty Liver Disease: Opportunities to Improve Treatment Outcomes Through Pharmacotherapy

Non-alcoholic Fatty Liver in Children and Adolescents in Saudi Arabia

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