What is the role of pioglitazone in the treatment of fatty liver disease?

Updated: Apr 12, 2018
  • Author: Emily Tommolino, MD; Chief Editor: BS Anand, MD  more...
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A randomized placebo-controlled trial comparing pioglitazone plus diet with diet alone in 55 patients undergoing liver biopsy reported improvements in the transaminase levels and steatosis; however, the fibrosis score improved only within the pioglitazone group before, not after, the 6-month treatment. [53] The posttreatment differences between the pioglitazone group and the placebo group were not statistically significant. Larger, longer studies are warranted.

In a study published in 2010, nearly 250 patients with NASH were divided into three groups as follows [54] :

  • Group 1, pioglitazone 30 mg/day

  • Group 2, vitamin E 800 IU/day

  • Group 3, placebo

After 96 weeks, each patient underwent a follow-up liver biopsy. Group 2 patients showed the most improvement on their liver biopsies. Both group 1 and group 2 patients showed improvements in liver lab test results and fatty liver inflammation numbers. However, group 1 patients gained the most weight and did not improve their liver scar readings. [54]

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