Conferences and Medical Updates
DDW NASH update : Dr Hwan Yoo
i. NASH if F2
ii. Progression more likely in DM, high ALT or high A2
iii. Potential regimens for NASH : Exenatide (byetta), Metformin plus omega 3 FA, FXR agonist such as OCA or change in gut microbiome with rifaximin or insulin type prebiotic or silymarin (component of milk thistle)
iv. Metformin plus PUFA 1 gm / day : Improved parameters associated with fibrosis
v. PPAR agonist : PanPPAR agonist elafibranor 80 mg / day : reduced fibrosis and resolution of NASH and improved biochemical markers : Investigations drug IVA337
vi. Bioactive lipids : have anit apoptic effective and anti inflammatory effect.
vii. Silymarin : improves elastography and inflammation score
viii. New studies to come out FLINT and Regenerate study
ix. Rifaximin 1100 mg / day. Showed biochemical and metabolic markers.
x. Insulin type prebiotic : InerginR 16 gm/day helps especially in DM and high BMI
xi. Rifaximin was better than norfloxacin for SBP prophylaxis :1200 mg refiaximin /day
xii. Cipro once a week is as good as norfloxacin daily