A COMPREHENSIVE REVIEW ON EVALUATION OF CLINICAL, BIOCHEMICAL AND IMAGING OUTCOMES OF SAROGLITAZAR AND VITAMIN E IN NON ALCOHOLIC FATTY LIVER DISEASE

Sreemantula Divya*, Asthapuram Sahaja, Sakkeri Nikitha, Sutharapu Divya, Dr. Moka Praneeth and Dr. Tirunagari Mamatha

ABSTRACT

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of diseases, involving excessive lipid deposition in the liver and is often accompanied by obesity, diabetes, dyslipidaemia, abnormal blood pressure, and other metabolic disorders. NAFLD is also called as metabolic dysfunction-associated steatotic liver disease [MASLD]. The estimated global incidence of NAFLD is 47 cases per 1000 population and is higher among males than females. In India, the overall prevalence of NAFLD in the general population is close to 40 percent. It is diagnosed by Ultrasound and LFT. Current treatment strategies mainly involve lifestyle modifications, such as weight loss and dietary modifications. Agents tested with some success in non-diabetic patients with NASH include pioglitazone, liraglutide, vitamin E and to a lesser degree, pentoxifylline. In patients with T2DM and NASH only pioglitazone has shown to significantly improve liver histology, with only a handful of patients with diabetes having been studied with other modalities. Glucagon-like peptide-1 analogue, FXR agonist, multi- strain reduces the fatty liver index, and aminotransferase levels in NAFLD patients. Sodium- dependent glucose cotransporter inhibitors, and peroxisome proliferator-activated receptor agonists have shown benefits in improving metabolic parameters and reducing hepatic lipid accumulation and inflammation. Saroglitazar is a drug that acts as a dual Peroxisome Proliferator-Activated Receptor (PPAR) alpha/gamma agonist and reduces liver fat and inflammation and has been shown to be efficacious in NAFLD by reduction of transaminase levels, improvement in overall metabolic health, reduction of liver fat content, and improvement of liver stiffness and histology. On the other hand, Vitamin E, a fat-soluble vitamin, which reduces liver inflammation. Antioxidants, anti-inflammatory and anti – apoptotic properties of vitamin E accompanied by ease-of-use and exceptional tolerability have made vitamin E a pragmatic therapeutic choice in NAFLD.

Keywords: NAFLD, Metabolic disorders, MASLD, Saroglitazar, Vitamin E