Abstract | BACKGROUND:
Thiazolidinediones (TZDs) have been used in the treatment of non- alcoholic steatohepatitis (NASH). However, the magnitude of treatment response associated with TZDs in improving liver histology in NASH has not been quantified systematically. AIM: To conduct a meta-analysis of randomised, placebo-controlled clinical trials (RPCTs) using pioglitazone and rosiglitazone in the treatment of NASH. METHODS: Pubmed/MEDLINE and Cochrane Central Register of Controlled Trials 2010 were searched until September 2010 and four RPCTs were identified. Peto odds ratios ( ORs) and their respective 95% confidence intervals (CIs) were used to assess the efficacy of TZDs in improving liver histological parameters. RESULTS: Four good quality RPCTs derived from three continents were included. The meta-analysis showed that TZDs (n = 169) were significantly better than placebo (n = 165) in improving ballooning degeneration, lobular inflammation and steatosis with combined ORs of 2.11 (95% CI, 1.33-3.36), 2.58 (95% CI, 1.68-3.97) and 3.39 (95% CI, 2.19-5.25) respectively. The improvement in combined necroinflammation with TZD (n = 58) vs. placebo (n = 52) was also statistically significant (combined OR 6.52[95% CI, 3.03-14.06]), but improvement in fibrosis was not. When pioglitazone (n = 137) was analysed alone, the improvement in fibrosis with pioglitazone (n = 137) vs. placebo (n = 134) (combined OR 1.68 [95% CI, 1.02-2.77]) was statistically significant. The total body fat slightly decreased in the control, while it markedly and highly significantly increased with TZD treatment. CONCLUSIONS:
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Authors | E Boettcher, G Csako, F Pucino, R Wesley, R Loomba |
Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 35
Issue 1
Pg. 66-75
(Jan 2012)
ISSN: 1365-2036 [Electronic] England |
PMID | 22050199
(Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | © 2011 Blackwell Publishing Ltd. |
Chemical References |
- Hypoglycemic Agents
- Thiazolidinediones
- Pioglitazone
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Topics |
- Fatty Liver
(complications, drug therapy)
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Liver
(drug effects)
- Liver Cirrhosis
(drug therapy)
- Non-alcoholic Fatty Liver Disease
- Pioglitazone
- Randomized Controlled Trials as Topic
- Thiazolidinediones
(therapeutic use)
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