Abstract
In The Lancet Gastroenterology & Hepatology, Takaomi Kessoku and colleagues 1 Kessoku T Imajo K Kobayashi T et al. Lubiprostone in patients with non-alcoholic fatty liver disease: a randomised, double-blind, placebo-controlled, phase 2a trial. Lancet Gastroenterol Hepatol. 2020; (published online Aug 14.)https://doi.org/10.1016/S2468-1253(20)30216-8 Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar report results from a 12-week, phase 2a, clinical trial comparing two doses of lubiprostone (24 μg and 12 μg) versus placebo in patients with non-alcoholic fatty liver disease (NAFLD). By contrast with other early stage clinical trials for this indication, the study specifically enrolled patients with a history of chronic constipation in addition to elevated alanine aminotransferase (ALT) and hepatic steatosis defined by MRI-proton density fat fraction (MRI-PDFF). The trial was done in Japan, where the prostaglandin E metabolite lubiprostone is approved for the treatment of chronic idiopathic constipation. Lubiprostone activates ClC-2 chloride channels on the luminal side in the gastrointestinal tract and leads to efflux of fluids and electrolytes, thus accelerating intestinal motility. 2 Lacy BE Levy LC Lubiprostone: a chloride channel activator. J Clin Gastroenterol. 2007; 41: 345-351 Crossref PubMed Scopus (83) Google Scholar Lubiprostone in patients with non-alcoholic fatty liver disease: a randomised, double-blind, placebo-controlled, phase 2a trialLubiprostone was well tolerated and reduced the levels of liver enzymes in patients with NAFLD and constipation. Further studies are necessary to better define the efficacy and tolerability of lubiprostone in patients with NAFLD without constipation. Full-Text PDF
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