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Drugs. 2019 Jun;79(9):903-927. doi: 10.1007/s40265-019-01126-9.

Fibrosis in Chronic Liver Disease: An Update on Diagnostic and Treatment Modalities.

Manka P1,2, Zeller A1, Syn WK3,4,5.

Author information

1
Gastroenterology and Hepatology, Essen University Hospital, Essen, Germany.
2
Division of Gastroenterology and Hepatology, Department of Medicine, Medical University of South Carolina, 30 Courtenay Drive, MSC 702, Room 402, Charleston, SC, 29425, USA.
3
Division of Gastroenterology and Hepatology, Department of Medicine, Medical University of South Carolina, 30 Courtenay Drive, MSC 702, Room 402, Charleston, SC, 29425, USA. synw@musc.edu.
4
Section of Gastroenterology, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA. synw@musc.edu.
5
Department of Physiology, Faculty of Medicine and Nursing, University of Basque Country UPV/EHU, Vizcaya, Spain. synw@musc.edu.

Abstract

Fibrosis is a common outcome of most chronic inflammatory diseases, characterized by the accumulation of excessive extracellular matrix components. Individuals with progressive liver fibrosis develop cirrhosis, are at risk of developing liver cancer, and may succumb to liver failure. Although a number of specific therapies for different diseases have been developed and successfully used, for example, direct antiviral agents in treatment for hepatitis C, effective and specific antifibrotic therapies are still not available. Liver biopsy remains the gold standard of staging liver fibrosis. However, transient elastography is increasingly being used in clinical trials and in hepatology clinics as part of standard-of-care evaluation because it is easy to use. Magnetic resonance (MR)-elastography is most accurate in evaluating fibrosis stage but is costly and time consuming and thus not readily available. Recent advances, however, have been made in areas of diagnostic and therapeutic modalities, with an increasing number of potential drugs currently in phase II and III trials, particularly in the field of non-alcoholic steatohepatitis-related liver fibrosis. These new drugs target multiple pathways involved in the pathogenesis of chronic liver disease, and we anticipate that some of them may soon be approved for use in patients.

PMID:
31119644
DOI:
10.1007/s40265-019-01126-9
[Indexed for MEDLINE]

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