title: Systematic review on the treatment of pentoxifylline in patients with non-alcoholic fatty liver disease.
abstract: BACKGROUND
  As an anti-TNF agent that targets inflammatory process directly, Pentoxifylline has been investigated for treatment of NASH in individual studies and pilot trials for years. We summarized the available information and generating hypotheses for future research.
  
  
  METHODS
  Google, Cochrane, MEDLINE, and EMBASE and the Chinese Biomedical data bases for studies restricted to pentoxifylline treatment in humans with NAFLD in all languages until June 2010. Six studies (2 randomized, double-blind, placebo-controlled trials; 4 prospective cohort studies) extracted from 11604 references.
  
  
  RESULTS
  Pentoxifylline-treated patients showed a significant decrease AST (n=37, P=0.01) and ALT (n=50, P=0.03), but no significant effect on IL-6 (n=36, P=0.33) and TNF-α (n=68, P=0.26) compared with Placebo or UDCA-controlled groups. Improvement in one or more histological variables was reported in two trails, only 1 study showed a reduction in of one or two points in fibrosis stage.
  
  
  CONCLUSIONS
  The trails did not consistently report all of the outcomes of interest. Sample sizes (117 patients totally) were small and only 2 out of 6 studies had a randomized, controlled design.
  
  
  CONCLUSIONS
  Pentoxifylline reduce AST and ALT levels and may improve liver histological scores in patients with NALFD/NASH, but did not appear to affect cytokines. Large, prospective, and well-designed randomized, controlled studies are needed to address this issue. Novel therapeutic targets for activation of inflammatory signaling pathways by fat also merit investigation.
authors.affiliation: Department of Endocrinology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Li
authors.forename: Liu
authors.initials: L
authors.lastname: Zheng
authors.forename: Chunjun
authors.initials: C
authors.lastname: Sheng
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Cheng
authors.forename: Liu
authors.initials: L
authors.lastname: Qing
authors.forename: Shen
authors.initials: S
authors.lastname: Qu
mesh_terms: D016207:Cytokines / Q000097:blood; D005234:Fatty Liver / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D065626:Non-alcoholic Fatty Liver Disease; D010431:Pentoxifylline / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D000637:Transaminases / Q000097:blood
chemical_list: D016207:Cytokines; D010726:Phosphodiesterase Inhibitors; D000637:Transaminases; D010431:Pentoxifylline