Clin Mol Hepatol.
2022 Jul;28(3):425-472. 10.3350/cmh.2022.0186.
Therapeutic mechanisms and beneficial effects of non-antidiabetic drugs in chronic liver diseases
- Affiliations
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- 1Departments of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- 2Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul, Korea
- 3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 4The Catholic University Liver Research Center, Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 5Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- 6Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- 7Yonsei Liver Center, Severance Hospital, Seoul, Korea
- 8Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
- 9Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- 10Department of Gastroenterology and Hepatology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
- 11Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 12Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- 13Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2531369
- DOI: http://doi.org/10.3350/cmh.2022.0186
Abstract
- The global burden of chronic liver disease (CLD) is substantial. Due to the limited indication of and accessibility to antiviral therapy in viral hepatitis and lack of effective pharmacological treatment in nonalcoholic fatty liver disease, the beneficial effects of antidiabetics and non–antidiabetics in clinical practice have been continuously investigated in patients with CLD. In this narrative review, we focused on non-antidiabetic drugs, including ursodeoxycholic acid, silymarin, dimethyl4,4’-dimethoxy-5,6,5’,6’-dimethylenedixoybiphenyl-2,2’-dicarboxylate, L-ornithine L-aspartate, branched chain amino acids, statin, probiotics, vitamin E, and aspirin, and summarized their beneficial effects in CLD. Based on the antioxidant, anti-inflammatory properties, and regulatory functions in glucose or lipid metabolism, several non–antidiabetic drugs have shown beneficial effects in improving liver histology, aminotransferase level, and metabolic parameters and reducing risks of hepatocellular carcinoma and mortality, without significant safety concerns, in patients with CLD. Although the effect as the centerpiece management in patients with CLD is not robust, the use of these non-antidiabetic drugs might be potentially beneficial as an adjuvant or combined treatment strategy.
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