(043) “Effect Of Pharmacological Interventions On Liver Function Parameters In Patients With NAFLD/NASH: A Systematic Review and Network meta-Analysis”

Background: Non-alcoholic fatty liver disease (NAFLD) has become a public health concern globally, but there is no approved treatment for the management of NAFLD development and progression.

Objectives: To assess the comparative efficacy of various interventions on liver function parameters in patients with NAFLD/NASH by conducting a systematic review and network meta-analysis (NMA).

Methods: Pubmed, Cochrane, and Google Scholar were searched for eligible studies belonging to the anti-diabetic drugs, anti-oxidants, anti-hypertensive drugs, lipid-lowering agents, pentoxifylline, and FXR agonists. Liver function parameters were considered as primary outcomes. The quality assessment was performed using the Cochrane risk of bias assessment tool, and the certainty of the evidence was assessed using the CINeMA approach. Inconsistency and publication bias were also assessed by net heat plots and funnel plots, respectively.

Results: A Total of 102 RCTs with a sample size of 7,665 NAFLD/NASH patients were included in the network meta-analysis. Meta-analysis results revealed that saroglitazar 4mg has shown a statistically significant effect in lowering AST, ALT, ALP, and GGT levels [(MD: -45.44; 95%CI: -66.04, -24.85), (MD: -75.10; 95%CI: -112.05, -38.14), (MD: -69.82; 95%CI: -92.93, -46.70), (MD: -101.85; 95%CI: -171.67, -32.04) respectively. It was found that there was no evidence of publication bias.

Conclusions: The present study concludes that saroglitazar 4mg is the best drug for lowering AST, ALT, ALP, and GGT levels when compared with the other included drugs. The evidence generated by our NMA could help the organizations for approving the drugs in the management of NAFLD.