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Vitamin E May Be Helpful in Nonalcoholic Steatohepatitis

Pioglitazone also shows some benefits compared with placebo in patients without diabetes

WEDNESDAY, April 28 (HealthDay News) -- Vitamin E may be an effective treatment for nonalcoholic steatohepatitis in adults without diabetes, and pioglitazone also has some benefits in treating the disease, according to research published online April 28 in the New England Journal of Medicine.

Arun J. Sanyal, M.D., of Virginia Commonwealth University in Richmond, and colleagues randomly assigned 247 adults without diabetes but with nonalcoholic steatohepatitis to receive either 30 mg pioglitazone daily, 800 IU vitamin E daily, or placebo (all for 96 weeks).

The researchers found that vitamin E was associated with significant improvement in histologic features of nonalcoholic steatohepatitis compared with placebo (43 versus 19 percent), but the difference in rate of improvement between pioglitazone and placebo was not significant. Compared with placebo, both vitamin E and pioglitazone reduced levels of serum alanine and aspartate aminotransferase, and both were associated with reduced hepatic steatosis and lobular inflammation, but neither improved fibrosis scores. In addition, subjects on pioglitazone gained more weight than the other subjects.

"Vitamin E was superior to placebo for the treatment of nonalcoholic steatohepatitis in adults without diabetes. There was no benefit of pioglitazone over placebo for the primary outcome; however, significant benefits of pioglitazone were observed for some of the secondary outcomes," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries, and one has been named on patents pending for biomarkers of nonalcoholic steatohepatitis.

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