title: An open-label randomized control study to compare the efficacy of vitamin e versus ursodeoxycholic acid in nondiabetic and noncirrhotic Indian NAFLD patients.
abstract: OBJECTIVE
  The study was carried out to compare the efficacy of Vitamin E versus Ursodeoxycholic acid (UDCA) in nondiabetic nonalcoholic fatty liver disease (NAFLD) patients.
  
  
  METHODS
  We randomized 250 non cirrhotic and non diabetic NAFLD patients diagnosed on ultrasound, with raised alanine aminotransferase (ALT) level. (>40 IU/L), to receive Vitamin E 400 mg twice a day (Group A) or UDCA 300 mg twice a day (Group B) for 52 weeks. Lifestyle modification to achieve at least 5% weight reduction and subsequent weight control and regular exercise was advised to both groups. The primary study endpoint was normalization of ALT. Secondary endpoints were the proportion of patients with reduction in ALT, relative reduction in the NAFLD Fibrosis score (NFS), symptomatic improvement and tolerability.
  
  
  RESULTS
  One hundred and fifty patients received UDCA as compared to 100 patients receiving Vitamin E. The treatment groups were comparable at entry with regard to age (44.1 vs 42.4 years), gender (67% vs 63% female), risk factors for nonalcoholic steatohepatitis, hypochondriac pain, serum liver biochemistries, and NAFLD Fibrosis score. The primary endpoint was achieved in 21 (14%) and 19 (19%) of patients in Group A and Group B, respectively (P = 0.2). The proportion of patients with reduction in ALT (56% vs 63%, P = 0.2), symptomatic improvement (78% vs 67%, P= 0.058), reduction in the NFS (44% vs 47%, P= 0.69), and tolerability (98% vs 95%, P= 0.2) were similar between Group A and Group B, respectively.
  
  
  CONCLUSIONS
  UDCA is an effective and safe alternative to Vitamin E in nondiabetic-noncirrhotic Indian NAFLD patients.
authors.affiliation: Department of Gastroenterology, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
authors.forename: Pathik
authors.initials: P
authors.lastname: Parikh
authors.affiliation: Department of Gastroenterology, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
authors.forename: Meghraj
authors.initials: M
authors.lastname: Ingle
authors.affiliation: Department of Gastroenterology, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
authors.forename: Jatin
authors.initials: J
authors.lastname: Patel
authors.affiliation: Department of Gastroenterology, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
authors.forename: Prasad
authors.initials: P
authors.lastname: Bhate
authors.affiliation: Department of Gastroenterology, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Pandey
authors.affiliation: Department of Gastroenterology, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
authors.forename: Prabha
authors.initials: P
authors.lastname: Sawant
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000975:Antioxidants / Q000008:administration & dosage*; D002756:Cholagogues and Choleretics / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000201:enzymology; D011446:Prospective Studies; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage*; D014810:Vitamin E / Q000008:administration & dosage*
chemical_list: D000975:Antioxidants; D002756:Cholagogues and Choleretics; D014810:Vitamin E; D014580:Ursodeoxycholic Acid; D000410:Alanine Transaminase