A Pilot Study Using Simvastatin in the Treatment of Nonalcoholic Steatohepatitis

Nelson, Austin; Torres, Dawn M.; Morgan, Ana E.; Fincke, Christopher; Harrison, Stephen A.

doi:10.1097/mcg.0b013e31819c392e

Cited by 251 publications

(177 citation statements)

References 41 publications

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“…[159][160][161][162][163][164][165][166][167] These studies consisted of small numbers of patients and have not been rigorously designed. A recent post-hoc analysis of the cardiovascular outcomes study, GREACE, 165 observed that statins significantly improve liver biochemistries and cardiovascular outcomes in patients with elevated liver enzymes likely due to NAFLD.…”

Section: Bariatric Surgerymentioning

confidence: 99%

The diagnosis and management of non-alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

et al. 2012

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Section: Bariatric Surgerymentioning

confidence: 99%

The diagnosis and management of non-alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

et al. 2012

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“…Fig. 3) and radiological steatosis [53,54] in hyperlipidaemic NAFLD patients; in the only RCT with post-treatment histology, simvastatin had no effect on liver histology [56]. There was no significant publication bias (ESM Fig.…”

Section: Lipid-lowering Drugsmentioning

confidence: 99%

“…Ezetimibe Growing evidence connects non-esterified cholesterol accumulation in mitochondria to hepatocyte apoptosis, liver injury and NASH development [56][57][58][59][60][61]. On this basis, ezetimibe, a Niemann-Pick C1 like 1 protein inhibitor, was evaluated in two RCTs in NAFLD.…”

mentioning

confidence: 99%

Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials

et al. 2012

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Aims/hypothesis Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum ranging from simple steatosis to non-alcoholic steatohepatitis (NASH): NAFLD causes an increased risk of cardiovascular disease, diabetes and liverrelated complications (the latter confined to NASH). The effect of proposed treatments on liver disease, glucose metabolism and cardiovascular risk in NAFLD is unknown. We reviewed the evidence for the management of liver disease and cardiometabolic risk in NAFLD. Methods Publications through November 2011 were systematically reviewed by two authors. Outcomes evaluated though standard methods were: histological/radiological/biochemical features of NAFLD, variables of glucose metabolism and cardiovascular risk factors. Seventy-eight randomised trials were included (38 in NASH, 40 in NAFLD): 41% assessed post-treatment histology, 71% assessed glucose metabolism and 88% assessed cardiovascular risk factors. Lifestyle intervention, thiazolidinediones, metformin and antioxidants were most extensively evaluated. Results Lifestyle-induced weight loss was safe and improved cardio-metabolic risk profile; a weight loss ≥7% improved histological disease activity, but was achieved by <50%

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“…2-4). 40 Trials in NAFLD. An RCT (quality score 8) randomized 186 hyperlipidemic NAFLD patients to 12 months of lifestyle advice plus atorvastatin, fenofibrate, or a combination of both (Table 1; Fig.…”

Section: Statinsmentioning

confidence: 99%

A Meta-Analysis of Randomized Trials for the Treatment of Nonalcoholic Fatty Liver Disease

Musso¹,

Gambino²,

Cassader³

et al. 2010

Hepatology

518

436

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Nonalcoholic fatty liver disease (NAFLD) encompasses a histological spectrum ranging from simple steatosis to nonalcoholic steatohepatitis (NASH). NAFLD carries a higher risk of cardio-metabolic and liver-related complications, the latter being confined to NASH and demanding specific treatment. We assessed the efficacy of proposed treatments for NAFLD/NASH by reviewing reports of randomized controlled trials (RCTs) on online databases and national and international meeting abstracts through January 2010. Primary outcome measure was histological improvement; secondary outcome was biochemical improvement; improvement in radiological steatosis was also evaluated. Two reviewers extracted articles using predefined quality indicators, independently and in duplicate. Main outcomes of randomized controlled trials (RCTs) were pooled using random-effects or fixed-effects models. Publication bias was assessed by funnel plots. Forty-nine RCTs (30 in NASH) were included: 23 RCTs (22 in NASH, 1 in NAFLD) had post-treatment histology. Most RCTs were small and did not exceed 1-year duration. Weight loss, thiazolidinediones (especially pioglitazone), and antioxidants were most extensively evaluated. Weight loss was safe and dose-dependently improved histological disease activity in NASH, but more than 50% of patients failed to achieve target weight loss. Thiazolidinediones improved steatosis and inflammation but yielded significant weight gain. RCTs with antioxidants yielded conflicting results and were heterogeneous with respect to type and dose of drug, duration, implementation of lifestyle intervention. Among the other agents, pentoxifylline, telmisartan and L-carnitine improved liver histology in at least 1 RCT in NASH; polyunsaturated fatty acid (PUFA) ameliorated biochemical and radiological markers of NAFLD. Other approaches yielded negative results. Conclusion: Well-designed RCTs of adequate size and duration, with histological endpoints, are needed to assess long-term safety and efficacy of proposed treatments on patient-oriented clinical outcomes. (HEPATOLOGY 2010;52:79-104)

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A Pilot Study Using Simvastatin in the Treatment of Nonalcoholic Steatohepatitis

Abstract: In this pilot trial, monotherapy with simvastatin does not seem to be an effective treatment for NASH.

Cited by 251 publications

References 41 publications

The diagnosis and management of non-alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

The diagnosis and management of non-alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials

A Meta-Analysis of Randomized Trials for the Treatment of Nonalcoholic Fatty Liver Disease

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