It has been well established that
S-adenosyl-L-methionine (SAMe) is the principal methyl donor in
methyltransferase reactions and that SAMe supplementation restores hepatic
glutathione (GSH) deposits and attenuates liver injury. However, the effectiveness of SAMe
therapy in chronic
liver disease has not been adequately addressed. We searched globally recognized electronic databases, including PubMed, the Cochrane Database and EMBASE, to retrieve relevant randomized controlled trials (RCTs) of chronic
liver disease published in the past 20 years. We then performed a systematic review and meta-analysis of the enrolled trials that met the inclusion criteria.The results showed that twelve RCTs from 11 studies, which examined 705 patients, were included in this research. For liver function, certain results obtained from data synthesis and independent comparisons demonstrated significant differences between the levels of total
bilirubin (TBIL) and
aspartate transaminase (AST). However, no studies identified significant differences regarding
alanine transaminase (ALT) levels. An analysis of the adverse events and long-term prognosis also indicated no significant differences between the SAMe and the placebo groups. In a subgroup analysis of gravidas and children, several of the included data indicated that there was a significant difference in the
pruritus score. Furthermore, the results regarding
ursodeoxycholic acid (UDCA) and
stronger neo-minophagen C (SNMC) indicated that both treatments were more effective than SAMe was in certain chronic
liver diseases. These findings suggest that SAMe could be used as the basis of a medication regimen for liver function improvement because of its safety. However, SAMe also demonstrated limited clinical value in the treatment of certain chronic
liver diseases.