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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

Family Practice

Advisor

Dr. Elyse Watkins

Abstract

Introduction: With NAFLD and NASH incidence on the rise and slated to be the leading cause of liver transplant in coming years, prevention, identification, and treatment will become paramount responsibilities of primary care providers. Current treatment for NASH/NAFLD includes counseling on diet and exercise but does not include consistent pharmaceutical intervention. GLP-1 RAs have shown significant promise regarding treating both obesity and diabetes which are known to occur concomitantly with NASH/NAFLD.

Methods: A PubMed search was done on articles published within the past five years, English language, humans, adults, RCT’s and meta-analysis. This yielded 24 articles. Fifteen articles were then excluded because their patient population was only focused on type II diabetics, a subset of the patient group with NASH/NAFLD. One study was excluded because it was a personal review article, and four studies were excluded because they were not applicable to the clinical question being asked. This left four high quality articles to review. In further review of these four studies, two of the studies were continuums of each other so one was excluded. With limits and exclusion criteria, three studies were analyzed that looked at treating NASH with GLP-1 RAs.

Results: Studies showed promise regarding stopping the progression of NASH with GLP-1 RAs; however, more evidence is needed to further support this treatment plan.

Conclusion: GLP-1 RAs are showing promise as a potential treatment choice for NASH/NAFLD especially given their known efficacy on weight loss and management of type II diabetes mellitus. Data from three randomized control trials showed potential promise for using GLP-1 RAs for the treatment of NASH/NAFLD; however, data is mixed and does not give clear guidelines for use. There needs to be a larger clinical trial that lasts for a longer period to determine if these medications will be a viable treatment option.

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