{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:41:59Z","timestamp":1787654519749,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare different treatments for non\u2010alcoholic steatohepatitis (NASH) and to<\/jats:p>\n                    <jats:p>determine an effectiveness hierarchy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and Bayesian network meta\u2010analysis including randomized controlled trials or prospective trials with at least 6\u2009months' follow\u2010up and histologically proven NASH in adult participants. Monte Carlo simulations were performed, each generating 10\u2009000 data points, and results are reported as medians and 95% credibility intervals (CrIs). A meta\u2010regression was conducted to find the effects of body mass index (BMI) decrement or reduction of homeostatic model assessment of insulin resistance (HOMA\u2010IR) index on non\u2010alcoholic fatty liver disease activity score (NAS) change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The review identified 48 eligible trials comprising 2356 adults (55.6% men). Data were pooled using a random\n                      <jats:bold>\n                        <jats:italic>\u2010<\/jats:italic>\n                      <\/jats:bold>\n                      effects model. The most effective treatments in terms of NAS reduction per semester were pioglitazone and Roux\u2010en\u2010Y gastric bypass (RYGB; \u22121.50 [95% CrI \u22122.08, \u22121.00] for pioglitazione and \u22121.00 [95% CrI \u22121.70, \u22120.32] for RYGB). Pioglitazone was also the best therapy for steatosis and lobular inflammation reduction. RYGB was the best treatment for hepatocellular ballooning reduction, whereas antioxidants appeared to be best for fibrosis improvement. For each 1% decrement in BMI, NAS was reduced by 1.3% (\u03b2 = 1.28%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01). Conversely, a 1% reduction of HOMA\u2010IR index reduced NAS by 0.3% (\u03b2 = 0.31%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Treatments that were regarded as promising, such as elafibranor, simtuzumab, selonsertib, cenicriviroc, obeticholic acid and liraglutide, did not reduce either NAS or liver fibrosis significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pioglitazione and RYGB are the most effective therapies for NASH. Antioxidants may be effective in reducing liver fibrosis. Weight loss and improvement of hepatic insulin resistance are promising approaches in the treatment of NASH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.14304","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T10:23:18Z","timestamp":1608805398000},"page":"980-990","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Pioglitazone and bariatric surgery are the most effective treatments for non\u2010alcoholic steatohepatitis: A hierarchical network meta\u2010analysis"],"prefix":"10.1111","volume":"23","author":[{"given":"Simona","family":"Panunzi","sequence":"first","affiliation":[{"name":"CNR\u2010IASI, Laboratorio di Biomatematica, Consiglio Nazionale delle Ricerche, Istituto di Analisi dei Sistemi ed Informatica  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Maltese","sequence":"additional","affiliation":[{"name":"CNR\u2010IRIB, Consiglio Nazionale delle Ricerche, Istituto per la Ricerca e l'Innovazione Biomedica  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ornella","family":"Verrastro","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Labbate","sequence":"additional","affiliation":[{"name":"CNR\u2010IRIB, Consiglio Nazionale delle Ricerche, Istituto per la Ricerca e l'Innovazione Biomedica  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"De Gaetano","sequence":"additional","affiliation":[{"name":"CNR\u2010IASI, Laboratorio di Biomatematica, Consiglio Nazionale delle Ricerche, Istituto di Analisi dei Sistemi ed Informatica  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Pompili","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmeralda","family":"Capristo","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan R.","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Department of Medicine III Universit\u00e4tsklinikum Carl Gustav Carus an der Technischen Universit\u00e4t Dresden  Dresden Germany"},{"name":"Division of Diabetes and Nutritional Sciences Faculty of Life Sciences and Medicine, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2021-528X","authenticated-orcid":false,"given":"Geltrude","family":"Mingrone","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. 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