{"id":1139,"date":"2024-01-17T09:07:54","date_gmt":"2024-01-17T09:07:54","guid":{"rendered":"https:\/\/www.the-nash-education-program.com\/?page_id=1139"},"modified":"2024-01-17T09:07:54","modified_gmt":"2024-01-17T09:07:54","slug":"how-is-nash-managed","status":"publish","type":"page","link":"https:\/\/www.the-nash-education-program.com\/what-is-nash\/how-is-nash-managed\/","title":{"rendered":"HOW IS NASH MANAGED?"},"content":{"rendered":"\n

There are two key challenges when considering a NASH diagnosis. The first involves identifying at-risk patients. The second involves determining the level of risk a patient is facing. Successfully identifying a patient\u2019s current stage and their risk of progressing can help you make more confident diagnoses and treatment recommendations. The chart below offers some helpful guidelines.<\/p>\n\n\n\n

MANAGING NASH1<\/sup><\/h2>\n\n\n\n

NASH treatment is rapidly changing and new, more effective treatments are on the horizon.2<\/sup> But for now, it will take awareness, vigilance, and careful risk-benefit analysis to change the lives of NASH and NAFLD patients.<\/p>\n\n\n\n

Below are guidelines from the American Association for the Study of Liver Diseases (AASLD).3<\/sup> While none of the treatment options below have been approved for the treatment of NASH, it may be a good place to start.<\/p>\n\n\n\n

AASLD Guidance Statements<\/th><\/tr>
Lifestyle Intervention<\/td>Combination of hypocaloric diet and moderate-intensity exercise provide best likelihood of sustained weight loss.Weight loss of at least 3-5% body weight to improve steatosis.Weight loss of 7-10% to improve majority of histopathological features of NASH including fibrosis.<\/td><\/tr>
Metformin<\/td>Not recommended for treating NASH in adult patients<\/td><\/tr>
Pioglitazone<\/td>May be used to treat patients with and without T2DM with biopsy-proven NASH. Risks and benefits should be discussed.Should not be used to treat NAFLD without biopsy-proven NASH.<\/td><\/tr>
GLP-1 analogues<\/td>Premature to consider GLP-1 agonists to specifically treat liver disease in patients with NAFLD or NASH.<\/td><\/tr>
Vitamin E<\/td>May be used for nondiabetic adults with biopsy-proven NASH. Risks and benefits should be discussed.Not recommended to treat NASH in diabetic patients, NAFLD without liver biopsy, NASH cirrhosis or cryptogenic cirrhosis until further data supporting Vit E effectiveness become available.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

OFFICIAL GUIDELINES<\/h2>\n\n\n\n

<\/h2>\n\n\n\n

American Association for the Study of Liver Disease (Last edition: 2018)<\/h4>\n\n\n\n

AASLD<\/a><\/p>\n\n\n\n

<\/h2>\n\n\n\n

European Association for the Study of the Liver
(Last edition: 2016)<\/h4>\n\n\n\n

EASL<\/a><\/p>\n\n\n\n

<\/h2>\n\n\n\n

The European Society for Pediatric
Gastroenterology, Hepatology and Nutrition
(Last edition: 2012)<\/h4>\n\n\n\n

ESPGHAN<\/a><\/p>\n\n\n\n

<\/h2>\n\n\n\n

North American Society for Pediatric Gastroenterology Hepatology and Nutrition
(Last edition: 2017)<\/h4>\n\n\n\n

NASPGHAN<\/a><\/p>\n\n\n\n

EXPLORE OUR EDUCATIONAL BROCHURES<\/a><\/p>\n\n\n\n

References<\/p>\n\n\n\n

    \n
  1. Rinella ME, Sanyal AJ. Management of NAFLD: a stage-based approach. Nature<\/em>. 2016;13:196-205.<\/li>\n\n\n\n
  2. Sumida Y, Yoneda M. Current and future pharmacological therapies for NAFLD\/NASH. J Gastroenterol<\/em>. 2018;53(3):362-376.<\/li>\n\n\n\n
  3. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology<\/em>. 2012;55(6):2005-2023.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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