Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis.

Study answer

What this study found

Vitamin E improved liver histology versus placebo in adults without diabetes with NASH. The primary histologic improvement endpoint was achieved in 43% versus 19% with placebo (P = 0.001; number needed to treat 4.2), and resolution of definite NASH occurred in 36% versus 21% (P = 0.05). Vitamin E also improved steatosis, lobular inflammation, hepatocellular ballooning, and total NAFLD activity score (mean change -1.9 versus -0.5). Insulin resistance and liver enzymes improved, quality-of-life scores did not differ significantly, and weight gain was not a major signal with vitamin E.

Study & population

Multicenter randomized placebo-controlled trial in adults without diabetes and biopsy-confirmed nonalcoholic steatohepatitis.

Intervention

Vitamin E (natural form, 800 IU orally once daily as a softgelatin capsule) was administered for 96 weeks.

Key limitation

Generalizability is limited to adults without diabetes with biopsy-confirmed NASH.

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Original abstract