studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1299A
Arun J. Sanyal - Advisory Committees or Review Panels: Bristol Myers, Gilead,
Genfit, Abbott, Ikaria, Exhalenz; Consulting: Salix, Immuron, Exhalenz, Nimbus,
Genentech, Echosens, Takeda, Merck, Enanta, Zafgen, JD Pharma, Islet
Sciences; Grant/Research Support: Salix, Genentech, Intercept, Ikaria, Takeda,
GalMed, Novartis, Gilead, Tobira; Independent Contractor: UpToDate, Elsevier
Rohit Loomba - Advisory Committees or Review Panels: Galmed Inc, Tobira Inc,
Arrowhead Research Inc; Consulting: Gilead Inc, Corgenix Inc, Janssen and
Janssen Inc, Zafgen Inc, Celgene Inc, Alnylam Inc, Inanta Inc, Deutrx Inc; Grant/
Research Support: Daiichi Sankyo Inc, AGA, Merck Inc, Promedior Inc, Kinemed
Inc, Immuron Inc, Adheron Inc
Stephen H. Caldwell - Advisory Committees or Review Panels: Vital Therapy;
Grant/Research Support: Genfit, Gilead Sciences, Immuron, Hyperion, Immuron,
NGM
Reem H. Ghalib - Grant/Research Support: Bristol Myers Squibb Pharmaceuticals,
Vertex Pharmaceuticals, Janssen, Merck, Genentech, Idenix, Zymogenetics,
Pharmasset, Anadys, Duke Clinical Research Institute, Achillion, Boehringer Ingelheim,
Gilead Pharmaceuticals, Virochem Pharmaceuticals, Abbott, Medtronic
Inc, Novartitis, Roche, Schering Plough, Salix, tibotec, Inhibitex, Takeda, Abbvie
Dawn M. Torres - Advisory Committees or Review Panels: Genetech; Speaking
and Teaching: Merck
Andrew J. Muir - Advisory Committees or Review Panels: BMS, Gilead, Janssen,
Merck; Consulting: Theravance; Grant/Research Support: Abbvie, Abbvie, BMS,
Gilead, Janssen, Merck, Achillion, Lumena
Robert P. Myers - Employment: Gilead Sciences, Inc.; Stock Shareholder: Gilead
Sciences, Inc.
Raul E. Aguilar Schall - Employment: Gilead Sciences, Inc.
Mani Subramanian - Employment: Gilead Sciences
John G. McHutchison - Employment: Gilead Sciences; Stock Shareholder: Gilead
Sciences
Jaime Bosch - Consulting: Falk, Gilead Science, Intercept Therapeutics, Conatus
Pharmaceuticals, Exalenz, Almirall, Chiasma
Stephen A. Harrison - Advisory Committees or Review Panels: Merck, Nimbus
Discovery, Fibrogen, RuiYi, CLDF; Consulting: NGM Biopharmaceuticals; Speaking
and Teaching: Gilead, Abbvie, Janssen, CLDF
Manal F. Abdelmalek - Consulting: Islet Sciences; Grant/Research Support:
Tobira, Gilead Sciences, NIH/NIDDK, Synageva, Genfit Pharmaceuticals,
Immuron, Galmed, TaiwanJ Pharma, Intercept, NGM Pharmaceuticals
The following authors have nothing to disclose: Arthur J. McCullough
2240
The effectiveness of SGLT-2 inhibitors as second-line
treatments for NAFLD patients with type 2 diabetes
mellitus who failed to incretin based therapy including
GLP-1 analogues and DPP-4 inhibitors
Takamasa Ohki 1 , Isogawa Akihiro 2 , Nobuo Toda 1 ; 1 Gastroenterology,
Mitsui Memorial Hospital, Tokyo, Japan; 2 Diabetes and
Metabolism, Mitsui Memorial Hospital, Tokyo, Japan
Background: We already reported that incretin based medicine,
such as GLP-1 analogues or DPP-4 inhibitors, improved
glycaemic control and liver inflammation in non-alcoholic fatty
liver disease (NAFLD) patients with type 2 diabetes mellitus
(T2DM). However, the effect on ALT normalization was still
limited. Aims: The aim of this study is to elucidate the effectiveness
of sodium-glucose co-transporter 2 (SGLT-2) inhibitors
as second-line treatments for NAFLD patients with T2DM who
failed to incretin based therapy. Methods: We retrospectively
enrolled consecutive 130 Japanese NAFLD patients with T2DM
who were treated with GLP-1 analogues or DPP-4 inhibitors.
Among them, 70 (53.8%) patients achieved normal ALT level
and the rest 60 (46.2%) patients did not. We finally obtained
informed consent from 24 (40.0%) patients out of 60 patients
and administered SGLT-2 inhibitors in addition to GLP-1 analogues
or DPP-4 inhibitors. We compared the changes of laboratory
data including ALT level and body weight at the end of
follow-up. Results: Thirteen patients were used in combination
with DPP-4 inhibitors and rest 11 patients were used in combination
with GLP-1 analogues. The median dosing period was
320 days. At the end of follow-up, body weight significantly
decreased (84.8 kg to 81.7 kg, P < 0.01) with amelioration
of HbA1c level (8.4% to 7.6%, P < 0.01). Serum ALT level
also significantly decreased (62 IU/l to 49 IU/l, P < 0.01)
with improvement of FIB-4 index (1.75 to 1.39, P = 0.04).
Univariate analysis indicated that 3% reduction of body weight
(OR: 12.0, 95%CI; 1.18-122, P = 0.04) as a factor which
contributed to normalization of serum ALT level. Conclusions:
Administration of SGLT-2 inhibitors led not only good glycaemic
control but also reduction of body weight, normalization of
ALT level, and alteration of FIB-4 index, even in patients who
failed to incretin based therapy.
Disclosures:
Takamasa Ohki - Speaking and Teaching: Otsuka Pharmaceutical Co. Ltd.
The following authors have nothing to disclose: Isogawa Akihiro, Nobuo Toda
2241
The impact of alcohol consumption for hepatocarcinogenesis
in Japanese fatty liver disease patients
Yusuke Kawamura 1,2 , Yasuji Arase 1,3 , Kenji Ikeda 1 , Yushi Sorin 1 ,
Hideo Kunimoto 1 , Hitomi Sezaki 1 , Tetsuya Hosaka 1 , Norio Akuta 1 ,
Masahiro Kobayashi 1 , Satoshi Saitoh 1 , Fumitaka Suzuki 1 , Yoshiyuki
Suzuki 1 , Mie Inao 2 , Satoshi Mochida 2 , Hiromitsu Kumada 1 ;
1 Hepatology, Toranomon Hospital, Tokyo, Japan; 2 Gastroenterology
and Hepatology, Saitama Medical University, Saitama,
Japan; 3 Health Management Center, Toranomon Hospital, Tokyo,
Japan
Background & Aims: The effect of ethanol consumption for
hepatocarcinogeneis of fatty liver is not clear. The aims of this
study were to determine the influence of alcohol consumption
on hepatocarcinogenesis and the risk factors for hepatocellular
carcinoma (HCC) in a large population of Japanese fatty liver
patients without viral hepatitis. Methods: This study was retrospective
cohort study and setting was specialized center for
hepatology. The study subjects were 9,959 patients with fatty
liver disease (FLD) without viral hepatitis diagnosed by ultrasonography.
In this study, the levels of daily ethanol consumption
divided into following four category;