The pharmacological management of NAFLD in children and adolescents.
Savinda LiyanagederaRobert Patrick WilliamsSilvio VeraldiValerio NobiliJake Peter MannPublished in: Expert review of clinical pharmacology (2017)
Non-alcoholic fatty liver disease (NAFLD) represents a spectrum, including 'simple' steatosis, non-alcoholic steatohepatitis (NASH), and fibrosis. Increasing prevalence of NAFLD has followed the international rise in obesity and lifestyle modification is the mainstay therapy for children. To date, pharmacological trials have had varying efficacy but a large number of new agents are in early phase trials for adults. Areas covered: This review explores the effect of current and potential future paediatric NAFLD treatments in terms of histological and biochemical endpoints. The potential for the extension of adult treatments to children is discussed, as well as what limits the use of certain agents in children. Expert commentary: No drugs have yet to be licenced for NAFLD. Trial heterogeneity makes comparison of drugs between studies challenging. FXR agonists are yet to be trialled in children but may represent a safe and potentially efficacious therapy. Future treatments would likely encompass a multimodal approach that may include bariatric surgery.
Keyphrases
- young adults
- bariatric surgery
- weight loss
- metabolic syndrome
- insulin resistance
- emergency department
- cardiovascular disease
- intensive care unit
- type diabetes
- high fat diet
- randomized controlled trial
- physical activity
- risk factors
- current status
- study protocol
- adipose tissue
- skeletal muscle
- liver injury
- high fat diet induced
- bone marrow
- open label
- human health
- chronic pain
- smoking cessation
- childhood cancer