From
EurekAlert!:
NIH-funded, NEJM study is largest ever to look at nonalcoholic steatohepatitis, an obesity-related condition
Vitamin E has been shown effective in treating nonalcoholic steatohepatitis (NASH), an obesity-associated chronic liver disease that can lead to cirrhosis, liver cancer, and death. NASH also is related to or a part of type 2 diabetes, lipid disorders and cardiovascular disease.
The often asymptomatic condition affects 2 to 5 percent of Americans, although an additional 10 to 20 percent of the population has fat in their liver, but no inflammation or liver damage, a condition called "fatty liver" that is a precursor to NASH. There is no established treatment.
The government-funded multicenter study was organized by the Nonalcoholic Steatohepatitis Clinical Research Network of the National Institute of Diabetes and Digestive and Kidney Diseases, and is the largest ever placebo-controlled randomized trial of treatment for NASH. Results are published in the April 28 online edition of the New England Journal of Medicine.
"There is an increasing prevalence of nonalcoholic steatohepatitis in this country, something that is directly related to the obesity epidemic," says Dr. Lavine, co-chair of the Network's steering committee and a co-author of the study. "The good news is that this study showed that cheap and readily available vitamin E can help many of those with the condition. We also looked at the drug pioglitazone, which showed some benefits, although not as dramatic as with vitamin E."
Dr. Lavine cautions that there are risks with any therapy, even vitamin E, and all treatment should be done under medical supervision.
After 96 weeks of treatment, vitamin E improved all features of NASH with the exception of the amount of scar tissue in the liver; 43 percent of those treated with vitamin E met the primary endpoint of the trial, which was a composite of the scores for several features of NASH indicative of disease activity, compared with only 19 percent of those who received a placebo.
Dr. Lavine joined NewYork-Presbyterian/Columbia from the University of California San Diego in February and brought his NIH grant for the study of fatty liver to NewYork-Presbyterian/Columbia. He is currently preparing a report on a multicenter study he led of vitamin E and the diabetes drug
metformin for NASH in children.