Publication details
Jsou tradiční hepatoprotektiva v terapii MASLD skutečně účinná?
| Title in English | Are traditional hepatoprotective agents truly effective in MASLD therapy? |
|---|---|
| Authors | |
| Year of publication | 2026 |
| Type | Peer-reviewed scientific article |
| Magazine / Source | BULLETIN SDRUŽENÍ PRAKTICKÝCH LÉKAŘŮ |
| Citation | |
| Keywords | MASLD; NAFLD; silymarin; essential phospholipids; tocopherol; S-adenosylmethionine |
| Description | The article begins by introducing one of the most common liver diseases today – metabolic dysfunction-associated fatty liver disease (MASLD), formerly known as NAFLD. It then outlines the options for pharmacotherapy and summarizes the available knowledge on traditional hepatoprotective agents registered in the Czech Republic, in particular silymarin, essential phospholipids, vitamin E, and adenosylmethionine. Although individual studies report partial improvement in some laboratory parameters, the overall evidence of the efficacy of these products in MASLD is weak, fragmentary, and insufficient for their routine recommendation. This fact is also reflected in current international recommendations, which do not recommend hepatoprotective agents in the treatment of MASLD. However, clinical practice shows that general practitioners encounter a wide range of patients with obesity, type 2 diabetes, metabolic syndrome, or regular alcohol consumption, whose common denominator is often MASLD or a disease with combined etiology (MetALD), or even alcohol-induced liver disease (ALD). For these patients, a consistent lifestyle change—weight reduction, diet modification, increased physical activity, and control of risk factors—is a fundamental therapeutic approach with proven benefits, while the administration of hepatoprotective agents has only a questionable effect. The situation is even more problematic with dietary supplements, whose quality and safety have been repeatedly questioned in the past. |