Ursodeoxycholic acid for treatment of nonalcoholic steatohepatitis: results of a randomized trial.
No effective medical therapy is available for all patients with nonalcoholic steatohepatitis (NASH). Ursodeoxycholic acid (UDCA) has been suggested to be of benefit based on open label clinical studies. We randomized 166 patients with liver biopsy-proven NASH to receive between 13 and 15 mg/kg/d of UDCA or placebo for 2 years. End points included changes in liver test results and liver histology at 2 years of therapy. The treatment groups were comparable at entry with regard to age, gender, risk factors for NASH, serum liver biochemistries, and baseline liver histology. A total of 126 patients completed 2 years of therapy. Pre- and posttreatment liver biopsies were available in 107 patients for review at the end of the study. UDCA was well tolerated and body weight was stable during the study duration. Serum liver biochemistries were stable or improved in both the UDCA and placebo-treated groups. Changes in the degree of steatosis, necroinflammation, or fibrosis that occurred with therapy were not significantly different between the UDCA and placebo groups. In conclusion, 2 years of therapy with UDCA at a dose of 13 to 15 mg/kg/d, although safe and well tolerated, is not better than placebo for patients with NASH.
Division of Gastroenterology and Hepatology, Mayo Clinic-W19A, 200 1st Street SW, Rochester, MN 55905, USA. lindor.keith@mayo.edu
Keith D
KD
Lindor
Kris V
KV
Kowdley
E Jenny
EJ
Heathcote
M Edwyn
ME
Harrison
Roberta
R
Jorgensen
Paul
P
Angulo
James F
JF
Lymp
Lawrence
L
Burgart
Patrick
P
Colin
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D018450:Disease Progression; D004311:Double-Blind Method; D005234:Fatty Liver / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D005355:Fibrosis; D006801:Humans; D008099:Liver / Q000473:pathology; D009336:Necrosis; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase