Research
Hormonal
Pioglitazone (PPAR-gamma agonist) improves histological features of NASH but is limited by problematic weight gain and is not widely adopted.
Pioglitazone can improve liver histology in NASH patients (34% vs 19% placebo), but it causes weight gain and is not widely used. It is considered only when lifestyle changes fail and other options are not suitable.
GoodQualifiesHIGH confidence
The same trial also studied pioglitazone... and found some histological improvement in patients with NASH (34% vs 19% placebo, p=0.04) but this did not meet prespecified cut-offs for efficacy... problematic weight gain with pioglitazone, neither treatment has been widely adopted in clinical practice.
Why this rating
Based on a cited RCT (Sanyal et al.) with statistically significant histological improvement (p=0.04).
Source
Non-alcoholic fatty liver disease
James Maurice et al. · Clinical Medicine · 2018
DOI 10.7861/clinmedicine.18-3-245
narrative_reviewCited 347×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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