Liver fibrosis as a major prognostic factor in chronic liver diseases and a key target for pharmacotherapy

Introduction. According to the available data from literature, non-alcoholic fatty liver disease (NAFLD) is the most common liver pathology in Russia and worldwide. The stage of liver fibrosis (LF) determines the prognosis for patients. Liver fibrogenesis is a potentially reversible process and requires timely initiation of therapy.

Aim. To provide current information on the prevalence of LF, the mechanisms of its development and therapeutic options in patients with NAFLD, as well as practical evaluation of the antifibrotic effects of essential phospholipid (EP) combined with glycyrrhizic acid (GA).

Materials and methods. A total of 83 people (mean age 61.4 ± 3.27 years, a male-to-female ratio 65:18, body mass index no more than 40 kg/m²) were included in the study. The stage of liver fibrotic changes was evaluated using dynamic ultrasound transient shear-wave fibroelastography before therapy initiation, at 6 and 12 months of therapy. The patients were divided into 2 groups: group 1 (n = 39) received a fixed-dose combination of EP/GA, group 2 (n = 44) received EP. Liver steatosis was the predominant condition in 59 individuals, while non-alcoholic steatohepatitis was present in 24 patients.

Results. The evaluation of six-month fixed-dose EP/GA therapy showed significant regression of LF indicators in group 1, which was mainly observed in fibrotic changes F2. After 12 months of fixed-dose EP/GA therapy, the number of patients with LF F2 and LF F3 also significantly regressed from 49% to 31% and from 38% to 23%, respectively. The EP monotherapy only demonstrated its efficacy in patients with fibrotic changes F1.

Conclusion. The fibrogenesis processes may be slowed down, and in some cases regressed, during the long-term use of the combination drug EP/GA, which demonstrated its efficacy and safety in clinical trials and in real-life clinical practice.

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