- nonalcoholic steatohepatitis NASH

nonalcoholic steatohepatitis NASH

Posted Thursday 19 August 2010 - 20:27 PM by David Chan

Second Line Drugs

VITAMINS, OTHER COMBINATIONS (A11JC)

Do not use -- ineffective or may be harmful

PIOGLITAZONE (A10BG03)

Reference

http://www.ncbi.nlm.nih.gov/pubmed/20427778?dop...

Comments/Instructions

InfoPOEM:
These findings will be touted as proof that vitamin E, and possibly pioglitazone (Actos), are effective treatments for nonalcoholic steatohepatitis. However, the danger of this condition is often overstated. Although the introduction to this study notes that up to 15% of patients progress to cirrhosis, this is in highly selected referral populations. The true incidence is much lower, as shown by progression of only 1 of 247 patients over the 2 years of this study. The histologic and biochemical "benefit" of vitamin E and pioglitazone must be balanced against the known harms of these drugs. For example, a previous meta-analysis found an excess of 1 death for every 300 patients randomized to receive vitamin E (Ann Intern Med 2005; 142:37-46; POEM 70254).

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