{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:43:24Z","timestamp":1783489404870,"version":"3.55.0"},"reference-count":58,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>With a steadily rising prevalence, nonalcoholic fatty liver disease (NAFLD) was a leading global cause of liver\u2010related health problems. In the clinical management of NAFLD, various western pharmaceuticals were widely utilized. This network meta\u2010analysis aimed to evaluate the effectiveness of common western medications for NAFLD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We systematically reviewed and screened articles based on predesigned criterion about western medications for NAFLD, which were from Embase, Cochrane Library, PubMed, CNKI, WanFang, and China Science and Technology Journal Database until August 1, 2024. Eligible studies included randomized controlled trials of patients aged 18 or older with NAFLD, comparing Western medicines to placebos or other Western medicine treatments. The risk of bias assessment tool 2.0 from the Cochrane system was used to assess the quality of the included articles. A Bayesian network meta\u2010analysis was conducted using WinBUGS 1.4.3 with a random\u2010effects model and Markov Chain Monte Carlo methods. Treatment rankings were based on Surface Under the Cumulative Ranking Curve (SUCRA) values, and heterogeneity was assessed with\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      and\n                      <jats:italic>Q<\/jats:italic>\n                      statistics. The outcomes were analyzed in WinBUGS and visualized using Stata 14.0, generating network plots and cumulative probability rankings to compare treatment effects. The systematic review was registered in PROSPERO (CRD42024509176).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on 37 included articles involving 7673 patients, pioglitazone demonstrated the most significant effects in resolving nonalcoholic steatohepatitis without worsening fibrosis, increasing high\u2010density lipoprotein cholesterol levels, and achieving a \u2265 2\u2010point reduction in NAFLD activity scores (odds ratio [OR] = 0.09, 95% confidence interval [CI]: 0.01 to 0.81), with a SUCRA probability of 91.4%. Aldafermin showed remarkable effects in improving liver function markers, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and \u03b3\u2010glutamyl transpeptidase, with cumulative probabilities of 90% for ALT and 69.8% for AST. Cluster analysis revealed that Resmetirom and Aldafermin were superior options for enhancing liver function, while pioglitazone emerged as the best treatment for the comprehensive improvement of NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pioglitazone outperformed other western medicines in terms of overall efficacy when treating NAFLD, but Aldafermin and Resmetirom showed superior improvement in liver function. This study provided a certain level of support for the use of specific clinical medications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jebm.70002","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T05:31:36Z","timestamp":1739856696000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical Assessment of Common Medications for Nonalcoholic Fatty Liver Disease: A Systematic Review and Bayesian Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"18","author":[{"given":"Rui","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyan","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiying","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanqi","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoguang","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1617-6110","authenticated-orcid":false,"given":"Jiarui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Chinese Pharmacy School of Chinese Materia Beijing University of Chinese Medicine  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"issue":"05","key":"e_1_2_7_2_1","first-page":"947","article-title":"Guidelines for the Prevention and Treatment of Non\u2010Alcoholic Fatty Liver Disease (2018 Update)","volume":"34","author":"National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association, Fatty Liver Expert Committee, Chinese Medical Doctor Association","year":"2018","journal-title":"Journal of Clinical Hepatology"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232415489"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.066"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32511-3"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.05.036"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10449"},{"issue":"20","key":"e_1_2_7_8_1","first-page":"2439","article-title":"Comparative Study on the Quality Assessment and Recommendations of Clinical Guidelines and Consensus for Non\u2010Alcoholic Fatty Liver Disease","volume":"26","author":"Zhang Z. 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