{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:45Z","timestamp":1787013885421,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polypharmacy is common among patients with multiple comorbidities but may compromise patient health due to medication interactions, cumulative side effects and compliance challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Characterise the extent of polypharmacy and assess the effects of sex, liver disease severity and comorbidities in patients with metabolic dysfunction associated steatotic liver disease (MASLD) in a real\u2010world setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from adults enrolled in TARGET\u2010NASH, a real\u2010world longitudinal observational cohort of patients with MASLD, were utilised. Reported medications were counted and relationships to disease severity, sex and insurance are described. Significant differences were identified using Chi\u2010square or Fisher's exact test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Medication use was evaluated in 5190 adults (59% female) in the United States with the full spectrum of MASLD revealing that 90% were prescribed five or more medications and 75% were prescribed ten or more medications (63% of whom were females). Patients with cirrhosis were often prescribed nonsteroidal anti\u2010inflammatory drugs (64%), opioids (55%), or benzodiazepines (45%). Females were prescribed more medications than males, particularly selective serotonin reuptake inhibitors (37% vs. 20%), opioids (44% vs. 37%), proton pump inhibitors (63% vs. 52%) and benzodiazepines (41% vs. 31%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Polypharmacy is common among patients with MASLD. Those with cirrhosis are most affected, and women with cirrhosis are at an even greater risk. Opioid, benzodiazepine, and nonsteroidal anti\u2010inflammatory drug use is prevalent among patients with cirrhosis despite the known associated risks. Frequent medication use for chronic pain in patients with cirrhosis highlights the need for management plans that optimise safety balanced against therapeutic efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70278","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T03:49:48Z","timestamp":1752724188000},"page":"920-938","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Magnitude of Polypharmacy and Role of Disease Severity and Patient Sex in Medication Use Among Patients With\n                    <scp>MASLD<\/scp>\n                    Enrolled in\n                    <scp>TARGET<\/scp>\n                    \u2010\n                    <scp>NASH<\/scp>"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8520-7398","authenticated-orcid":false,"given":"Brent A.","family":"Neuschwander\u2010Tetri","sequence":"first","affiliation":[{"name":"Saint Louis University  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather L.","family":"Morris","sequence":"additional","affiliation":[{"name":"Target RWE  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3419-8276","authenticated-orcid":false,"given":"Andrea R.","family":"Mospan","sequence":"additional","affiliation":[{"name":"Target RWE  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Yu","sequence":"additional","affiliation":[{"name":"Target RWE  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breda","family":"Munoz","sequence":"additional","affiliation":[{"name":"Target RWE  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheenu","family":"Abraham","sequence":"additional","affiliation":[{"name":"Target RWE  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Fried","sequence":"additional","affiliation":[{"name":"Target RWE  Durham North Carolina USA"},{"name":"University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"IV","given":"A. Sidney","family":"Barritt","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leen","family":"Al\u2010Sayyed","sequence":"additional","affiliation":[{"name":"BJC Medical Group  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8682-5748","authenticated-orcid":false,"given":"Arun J.","family":"Sanyal","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"TARGET\u2010NASH Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph14121207"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-021-02183-0"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/dtb.2022.000050"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(23)00036-3"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-081698"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0237186"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12292"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-37209-1"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.15990"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006761"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2017.07.015"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1689"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-017-0621-2"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-033322"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-021-00479-3"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098620933741"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16674"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000520"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.07.021"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.08.026"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.07.017"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.01.014"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002796"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.50963"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000019"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010214"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2022.100727"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15639"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229497"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1159\/000511074"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000337"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(00)00296-7"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(90)90027-2"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm16138"}],"container-title":["Alimentary Pharmacology &amp; 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