title: Ursodeoxycholic acid with vitamin E in patients with nonalcoholic steatohepatitis: long-term results.
abstract: BACKGROUND
  The combination of ursodeoxycholic acid (UDCA) and vitamin E is a therapeutic option for nonalcoholic steatohepatitis (NASH) but randomized controlled studies have produced inconsistent results. The objective of this study was to report the long-term tolerability and efficacy of this combination in our ten-year single center experience.
  
  
  METHODS
  The study group included 101 adult patients with persistent elevation of serum aminotransferases (AST and ALT) and/or γ glutamyl-transferase (GGT), in whom a histological diagnosis of NASH was made from January 1998 to January 2009, and who were treated with a combination of UDCA with vitamin E.
  
  
  RESULTS
  Median body mass index (30 kg/m(2)) remained unchanged during the study. UDCA and vitamin E were well tolerated (5% withdrawal for side effects). Mean serum AST, ALT and GGT levels (expressed as times of Upper Normal Limit) diminished significantly (1.39 ± 0.74 to 0.78 ± 0.34 for AST, 1.72 ± 0.92 to 0.91 ± 0.69 for AST and 3.25 ± 2.85 to 1.30 ± 1.30 for GGT). AST, ALT and GGT reached normal range in 80%, 70% and 65% of the patients, respectively. From the ten patients who had a second liver biopsy during follow-up, NAS score improved in seven, and worsened in one.
  
  
  CONCLUSIONS
  The combination of UDCA with vitamin E significantly improves liver function tests in long-term and is very well tolerated.
authors.affiliation: Hospices civils de Lyon pavillon H, hôpital Édouard- Herriot, fédération des spécialités digestives, 69437 Lyon cedex 03, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Pietu
authors.forename: Olivier
authors.initials: O
authors.lastname: Guillaud
authors.forename: Thomas
authors.initials: T
authors.lastname: Walter
authors.forename: Mélanie
authors.initials: M
authors.lastname: Vallin
authors.forename: Valérie
authors.initials: V
authors.lastname: Hervieu
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Scoazec
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dumortier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004359:Drug Therapy, Combination; D005234:Fatty Liver / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*; D014810:Vitamin E / Q000627:therapeutic use*; D014815:Vitamins / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014815:Vitamins; D014810:Vitamin E; D014580:Ursodeoxycholic Acid