Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials

<h3>Background</h3><p dir="ltr">Non-alcoholic steatohepatitis (NASH) is an advanced subtype of non-alcoholic fatty liver disease (NAFLD). NASH prevalence is increasing exponentially and carries a high risk for disease progression, cirrhosis, and liver-related mortality. A...

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Main Author: Mohamed Mahmoud Marey (18560902) (author)
Other Authors: Mohamed Belal (18560905) (author), Abdelaziz A. Awad (18560908) (author), Eslam Mohammed Rabea (18560911) (author), Malak A. Hassan (18560914) (author), Ahmed W. Abbas (18560917) (author), Abdulqadir J. Nashwan (11659453) (author)
Published: 2024
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_version_ 1864513515920818176
author Mohamed Mahmoud Marey (18560902)
author2 Mohamed Belal (18560905)
Abdelaziz A. Awad (18560908)
Eslam Mohammed Rabea (18560911)
Malak A. Hassan (18560914)
Ahmed W. Abbas (18560917)
Abdulqadir J. Nashwan (11659453)
author2_role author
author
author
author
author
author
author_facet Mohamed Mahmoud Marey (18560902)
Mohamed Belal (18560905)
Abdelaziz A. Awad (18560908)
Eslam Mohammed Rabea (18560911)
Malak A. Hassan (18560914)
Ahmed W. Abbas (18560917)
Abdulqadir J. Nashwan (11659453)
author_role author
dc.creator.none.fl_str_mv Mohamed Mahmoud Marey (18560902)
Mohamed Belal (18560905)
Abdelaziz A. Awad (18560908)
Eslam Mohammed Rabea (18560911)
Malak A. Hassan (18560914)
Ahmed W. Abbas (18560917)
Abdulqadir J. Nashwan (11659453)
dc.date.none.fl_str_mv 2024-06-01T00:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.clinre.2024.102357
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Efficacy_and_safety_of_aldafermin_in_non-alcoholic_steatohepatitis_A_systematic_review_and_meta-analysis_of_randomized_controlled_trials/25827250
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
NAFLD
NASH
Fatty liver
Aldafermin
FGF19
dc.title.none.fl_str_mv Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Non-alcoholic steatohepatitis (NASH) is an advanced subtype of non-alcoholic fatty liver disease (NAFLD). NASH prevalence is increasing exponentially and carries a high risk for disease progression, cirrhosis, and liver-related mortality. Aldafermin, a fibroblast growth factor 19 (FGF19) analog, is one of the evolving therapeutic agents with the potential to regulate multiple pathways involved in the pathogenesis of NASH. We aimed to investigate the efficacy and safety of aldafermin in patients with NASH.</p><p><br></p><h3>Methods</h3><p dir="ltr">PubMed, Scopus, Cochrane Library, and Web of Science were searched till November 2023 to identify eligible randomized controlled trials (RCTs). Continuous data were pooled as mean difference (MD), while dichotomous data were pooled as risk ratios (RR) with a 95 % confidence interval. A subgroup meta-analysis was conducted to evaluate the efficacy of the two doses (1 mg and 3 mg) of aldafermin.</p><p><br></p><h3>Results</h3><p dir="ltr">Four RCTs with a total of 491 patients were included. Aldafermin showed a dose-dependent improvement in the ≥30 % reduction in the liver fat content (RR: 2.16, 95 % CI [1.41 to 3.32]) and (RR: 5.00, 95 % CI [1.34 to 18.64]), alanine aminotransferase levels (MD: −19.79, 95 % CI [−30.28 to −9.3]) and (MD: −21.91, 95 % CI [−29.62 to −14.21]), aspartate aminotransferase levels (MD: −11.79, 95 % CI [−18.06 to −5.51]) and (MD: −13.9, 95 % CI [−18.59 to −9.21]), and enhanced liver fibrosis score (ELF) (MD: −0.13, 95 % CI [−0.29 to 0.02]) and (MD: −0.33, 95 % CI [−0.50 to −0.17]), in the 1 mg and 3 mg subgroups respectively. No significant differences were detected in the aldafermin group regarding histologic endpoints, lipid profile, metabolic parameters, and overall adverse effects, except for the increased occurrence of diarrhea in the aldafermin 3 mg subgroup.</p><p><br></p><h3>Conclusion</h3><p dir="ltr">Aldafermin is a promising well-tolerated therapeutic agent for NASH with evidence supporting its ability to reduce liver fat content, fibrosis serum biomarkers, and liver enzymes. However, its effectiveness in improving histologic fibrosis, while showing numerical trends, still lacks statistical significance. Larger and longer NASH trials are warranted to enhance the robustness of the evidence.</p><h2>Other Information</h2><p dir="ltr">Published in: Clinics and Research in Hepatology and Gastroenterology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.clinre.2024.102357" target="_blank">https://dx.doi.org/10.1016/j.clinre.2024.102357</a></p>
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identifier_str_mv 10.1016/j.clinre.2024.102357
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/25827250
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spelling Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trialsMohamed Mahmoud Marey (18560902)Mohamed Belal (18560905)Abdelaziz A. Awad (18560908)Eslam Mohammed Rabea (18560911)Malak A. Hassan (18560914)Ahmed W. Abbas (18560917)Abdulqadir J. Nashwan (11659453)Biomedical and clinical sciencesClinical sciencesNAFLDNASHFatty liverAldaferminFGF19<h3>Background</h3><p dir="ltr">Non-alcoholic steatohepatitis (NASH) is an advanced subtype of non-alcoholic fatty liver disease (NAFLD). NASH prevalence is increasing exponentially and carries a high risk for disease progression, cirrhosis, and liver-related mortality. Aldafermin, a fibroblast growth factor 19 (FGF19) analog, is one of the evolving therapeutic agents with the potential to regulate multiple pathways involved in the pathogenesis of NASH. We aimed to investigate the efficacy and safety of aldafermin in patients with NASH.</p><p><br></p><h3>Methods</h3><p dir="ltr">PubMed, Scopus, Cochrane Library, and Web of Science were searched till November 2023 to identify eligible randomized controlled trials (RCTs). Continuous data were pooled as mean difference (MD), while dichotomous data were pooled as risk ratios (RR) with a 95 % confidence interval. A subgroup meta-analysis was conducted to evaluate the efficacy of the two doses (1 mg and 3 mg) of aldafermin.</p><p><br></p><h3>Results</h3><p dir="ltr">Four RCTs with a total of 491 patients were included. Aldafermin showed a dose-dependent improvement in the ≥30 % reduction in the liver fat content (RR: 2.16, 95 % CI [1.41 to 3.32]) and (RR: 5.00, 95 % CI [1.34 to 18.64]), alanine aminotransferase levels (MD: −19.79, 95 % CI [−30.28 to −9.3]) and (MD: −21.91, 95 % CI [−29.62 to −14.21]), aspartate aminotransferase levels (MD: −11.79, 95 % CI [−18.06 to −5.51]) and (MD: −13.9, 95 % CI [−18.59 to −9.21]), and enhanced liver fibrosis score (ELF) (MD: −0.13, 95 % CI [−0.29 to 0.02]) and (MD: −0.33, 95 % CI [−0.50 to −0.17]), in the 1 mg and 3 mg subgroups respectively. No significant differences were detected in the aldafermin group regarding histologic endpoints, lipid profile, metabolic parameters, and overall adverse effects, except for the increased occurrence of diarrhea in the aldafermin 3 mg subgroup.</p><p><br></p><h3>Conclusion</h3><p dir="ltr">Aldafermin is a promising well-tolerated therapeutic agent for NASH with evidence supporting its ability to reduce liver fat content, fibrosis serum biomarkers, and liver enzymes. However, its effectiveness in improving histologic fibrosis, while showing numerical trends, still lacks statistical significance. Larger and longer NASH trials are warranted to enhance the robustness of the evidence.</p><h2>Other Information</h2><p dir="ltr">Published in: Clinics and Research in Hepatology and Gastroenterology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.clinre.2024.102357" target="_blank">https://dx.doi.org/10.1016/j.clinre.2024.102357</a></p>2024-06-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.clinre.2024.102357https://figshare.com/articles/journal_contribution/Efficacy_and_safety_of_aldafermin_in_non-alcoholic_steatohepatitis_A_systematic_review_and_meta-analysis_of_randomized_controlled_trials/25827250CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/258272502024-06-01T00:00:00Z
spellingShingle Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
Mohamed Mahmoud Marey (18560902)
Biomedical and clinical sciences
Clinical sciences
NAFLD
NASH
Fatty liver
Aldafermin
FGF19
status_str publishedVersion
title Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
title_full Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
title_fullStr Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
title_short Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
title_sort Efficacy and safety of aldafermin in non-alcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
topic Biomedical and clinical sciences
Clinical sciences
NAFLD
NASH
Fatty liver
Aldafermin
FGF19