Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis

Abstract

Forty-five patients completed 6 months of therapy without significant side effects. Vitamin treatment resulted in a statistically significant improvement in fibrosis score (p=0.002). No changes were noted in inflammation with treatment. Vitamin E and vitamin C, in the doses used in this study, were well tolerated and were effective in improving fibrosis scores in NASH patients. No improvement in necroinflammatory activity or ALT was seen with this combination of drug therapy. A larger, multicenter, longer-term trial with vitamin E and vitamin C seems to be warranted.

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

“…Vitamin E is an anti-oxidant and has been investigated to treat NASH. [124][125][126][127][128] Comparison between these trials is difficult due to varying criteria for entry into the study, different doses of vitamin E and unclear formulations of vitamin E used which could affect its bioavailability, the additional use of other anti-oxidants or other drugs and limited histologic data to assess outcomes. Also, most studies were relatively under-powered and did not meet or publish CONSORT criteria for clinical trials.…”

Mitochondrial dysfunction and oxidative stress in the pathogenesis of alcohol- and obesity-induced fatty liver diseases

“…And, like the therapeutic agents described above, results using antioxidants have been varied with some antioxidants showing positive effects and others not. In both adults and children with NASH, treatment with α-tocopherol (vitamin E) has been shown to improve serum liver enzymes [155][156][157]. Similarly, NASH patients treated with vitamin E (400 IU/day) and pioglitazone for 6 months showed significant improvement in liver histology over vitamin E treatment alone [158].…”

Non-alcoholic fatty liver disease: the hepatic consequence of obesity and the metabolic syndrome

“…A recent Cochrane review of six very small and extremely diverse clinical trials has found no evidence either to recommend or advise against the use of antioxidant supplements in patients with NAFLD (88) . However, data from pilot studies (89,90) and one double-blind randomised placebocontrolled trial (91) have shown sufficient positive effects of vitamin E supplementation in patients with NAFLD for further investigation in two ongoing multicentre trials. The Pioglitazone versus Vitamin E versus Placebo for the Treatment of Non-diabetic Patients with Non-alcoholic Steatohepatitis Trial (92) in adults and the Treatment of Non-alcoholic Fatty Liver Disease in Children Trial (93) both involve 96 weeks of treatment and will measure improvements in histology as well as ALT levels.…”