Promising a fresh development of millions of people with liver disease

It is estimated that almost four out of 10 American adults have a condition of the liver, which can lead to grave complications and even death. Commonly known as fatty liver disease, the disease is often unrecognized until the patient achieves eternal scars and liver damage, called cirrhosis.

Until recently, doctors could hope for intervening, suggesting changes in diet and lifestyle or helping patients in dealing with states such as diabetes or high cholesterol. But these efforts were often not enough. Now a promising fresh study shows that weight loss surgery can reduce the chances of grave complications, even in some patients with cirrhosis.

In the study, Published in Nature MedicineScientists analyzed data on patients with obesity and cirrhosis associated with the advanced form of fat liver disease called metabolic disorders associated with fatty inflammation or mash. Obesity is one of the main risk factors of Mash. In a 15-year point, patients who underwent bariatric surgery were 72 percent less likely that they developed grave complications, such as liver cancer than similar patients who had no surgery.

Discoveries, along with emerging research on the benefits of drug weight loss, gave doctors fresh hope to solve liver fat problems.

Mash begins with the accumulation of fat on the liver. In some patients, this leads to inflammation and fibrosis of the liver or scars. Studies have shown that significant weight loss can reverse fibrosis and improve long -term patient results. But liver cirrhosis was much more restricted.

“Most people assume that cirrhosis is a death sentence,” said Dr. Rotonya Carr, who is the head of gastroenterology at the University of Washington. But the emerging data suggest differently.

IN new The study, scientists from the Cleveland clinic returned by patients’ entries and identified 168 adults who had obesity – defined as a body mass index of 30 or more – and liver cirrhosis caused by the Whalep. (Liver cirrhosis can also be caused by prolonged consumption of alcohol and hepatitis). Researchers only included patients who “compensated” the cirrhosis of the liver, which means that they did not develop grave complications.

Among the patients who underwent surgery, 21 percent had at least one “main adverse liver result” by 15 years, compared to 46 percent of people who had no surgery. These results included fluid accumulation, confusion caused by toxins in the brain, bleeding from the esophagus and liver cancer.

Dr. Ali Aminian, director of the Bariatric and Metabolic Institute at Cleveland Clinic and the main author of the article, said that research suggests that significant, ongoing weight loss can prevent the further consequences of mice even in some of the worst patients.

“We tried to show if we deal with obesity and if we facilitate people lose weight, how can we change the trajectory of the disease?” Dr. Aminian said. The study was not financed by drug or devices manufacturers, but Dr. Aminian had previously consulted in the case of the drug manufacturer in slimming Ela Lilly and companies that create equipment used in bariatric surgery.

Dr. Vandana Khungar, a professor of medicine and deputy medical director of liver transplantation at the Yale University School of Medicine, noted that patients with cirrhosis are more exposed to complications after surgery. But the results of this study were impressive, she said that they showed that some patients could have “good safety results and excellent liver results” during surgery. Dr. Khungar was not involved in the examination.

He warns that individual risk and access to the center with experience in treating patients with liver cirrhosis should continue to determine whether surgery is a good option.

The study had several restrictions. He was based on the patient’s earlier data, and not from patients randomly in the treatment groups and was sometimes observed. The size of the sample was relatively miniature and covered mainly white patients. And although researchers have tried to include factors that can warn the data, it is possible that patients in both groups were different in a key way.

Despite this, experts expressed optimism as to the implication of the study, especially if weight loss from fresh drugs turned out to have a similar effect on liver cirrhosis.

A handful over the past few months Preliminary attempts Slimming drugs have shown that patients from drugs often see crucial features of mash, including hepatitis, and determination.

Early results with Phase 3 semaglutide test (Known under the brands of Ozempic and Wegovy) presented at a medical conference in December showed striking results: 63 percent of patients taking the drug saw how they are solved, compared to 34 percent of the placebo people. Patients at semaglutide also more often saw their fibrosis – which is divided into stages from 0 to 4 – they fall by at least one stage.

None of these studies studied the impact of weight loss drugs on cirrhosis, which is considered fibrosis in stage 4. But experts said that they hope that better treatments – including potentially bariatric surgery – may be on the horizon.