Hormonal
Pioglitazone (30 mg daily) improves biochemical and histological features of nonalcoholic steatohepatitis (NASH) in nondiabetic patients by redistributing lipid from the liver to peripheral adipose tissue, thereby reducing hepatic steatosis and inflammation.
For individuals with biopsy-proven NASH who are not diabetic, pioglitazone (30mg/day) can significantly improve liver inflammation and fat content over 48 weeks. However, this benefit comes with an average 4% weight gain due to increased body fat. This treatment requires strict medical supervision and monitoring, as it is not a routine therapy and long-term safety is still under study.
Pioglitazone was well tolerated; the main side effects were weight gain (averaging 4%) and an increase in total body adiposity. ... these results indicate that treatment with an insulin-sensitizing agent can lead to improvement in biochemical and histological features of NASH ... The TZDs ... may act by redistributing lipid from muscle and liver to peripheral adipocytes.
Why this rating
It is a pilot study with a small sample size (n=18) and lacks a concurrent control group, limiting the strength of causal inference regarding long-term safety and efficacy.
Source
A pilot study of pioglitazone treatment for nonalcoholic steatohepatitis† ‡
Kittichai Promrat et al. · Hepatology · 2004
DOI 10.1002/hep.20012
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