Hello, my name's Leon Adams from the Medical School of
the University of Western Australia in
the Department of Hepatology at Sir Charles Gairdner Hospital in Australia.
And today, I'll be talking about "Advances in the Treatment of Non-Alcoholic Steatohepatitis".
So, the talk today we'll be covering who to treat,
optimal lifestyle management in terms of nutritional therapy and exercise.
Pharmacotherapy with the current status of drugs and drugs that are emerging.
And lastly, finishing off on how to assess treatment response.
So firstly, looking at who to treat.
So, it's clear that patients with NAFLD are an at risk group with
an increased mortality rate compared to the age and sex matched general population.
One study found a 34 percent increased risk of all caused death,
with the leading causes of death in this population being cardiovascular disease,
malignancy, and liver disease.
There is now a compelling evidence that patients with NAFLD increased
risk of cardiovascular outcomes as well as liver disease outcomes.
And so, all patients should have a metabolic and cardiovascular risk assessment.
So, the first line of treatment for NAFLD patients should
consist of attention to the main metabolic drivers of NAFLD,
with weight loss and lifestyle management and
addressing metabolic risk factors such as diabetes,
and vascular risk factors such as smoking, hypertension, and dyslipidemia.
So, how do we optimize treatment for lifestyle management?
So, in terms of dietary treatment,
the questions we should be asking are
how much weight loss do we need to maximize treatment effect?
Which diet is the best diet for our patients?
And how can we achieve sustainability of nutritional or dietary therapy?