Document Type
Article
Publication Date
4-13-2021
Identifier
DOI: 10.3389/fendo.2021.663351; PMCID: PMC8076784
Abstract
Obesity is the single greatest risk factor for nonalcoholic fatty liver disease (NAFLD). Without intervention, most pediatric patients with NAFLD continue to gain excessive weight, making early, effective weight loss intervention key for disease treatment and prevention of NAFLD progression. Unfortunately, outside of a closely monitored research setting, which is not representative of the real world, lifestyle modification success for weight loss in children is low. Bariatric surgery, though effective, is invasive and can worsen NAFLD postoperatively. Thus, there is an evolving and underutilized role for pharmacotherapy in children, both for weight reduction and NAFLD management. In this perspective article, we provide an overview of the efficacy of weight reduction on pediatric NAFLD treatment, discuss the pros and cons of currently approved pharmacotherapy options, as well as drugs commonly used off-label for weight reduction in children and adolescents. We also highlight gaps in, and opportunities for, streamlining obesity trials to include NAFLD assessment as a valuable, secondary, therapeutic outcome measure, which may aid drug repurposing. Finally, we describe the already available, and emerging, minimally-invasive biomarkers of NAFLD that could offer a safe and convenient alternative to liver biopsy in pediatric obesity and NAFLD trials.
Journal Title
Front Endocrinol (Lausanne)
Volume
12
First Page
663351
Last Page
663351
Keywords
NAFLD; pediatric; pediatric NAFLD; pediatric trials; pharmacotherapy; weight losing effect; weight loss efficacy
Recommended Citation
Friesen CS, Hosey-Cojocari C, Chan SS, et al. Efficacy of Weight Reduction on Pediatric Nonalcoholic Fatty Liver Disease: Opportunities to Improve Treatment Outcomes Through Pharmacotherapy. Front Endocrinol (Lausanne). 2021;12:663351. Published 2021 Apr 13. doi:10.3389/fendo.2021.663351
Included in
Gastroenterology Commons, Pediatrics Commons, Pharmacology, Toxicology and Environmental Health Commons, Surgery Commons
Comments
his is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Publisher's Link: https://www.frontiersin.org/articles/10.3389/fendo.2021.663351/full