| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000418479 |
| ISSN: | 1665-2681 |
| Authors: | Van Wagner, Lisa B1 Koppe, Sean W.P1 Brunt, Elizabeth M2 Gottstein, Jeanne1 Gardikiotes, Konstantina1 Green, Richard M1 Rinella, Mary E1 |
| Institutions: | 1Northwestern University, Feinberg School of Medicine, Chicago, Illinois. Estados Unidos de América 2Washington University, School of Medicine, Saint Louis, Misuri. Estados Unidos de América |
| Year: | 2011 |
| Season: | Jul-Sep |
| Volumen: | 10 |
| Number: | 3 |
| Pages: | 277-286 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English abstract | The burden of non-alcoholic steatohepatitis (NASH) is growing and current pharmacologic treatments are limited by side effects and inconsistent efficacy. Pilot studies suggest that pentoxifylline (PTX) can reduce liver injury in patients with NASH. Objective. We sought to determine the tolerability of PTX and its effect on aminotransferases and liver histology in patients with NASH. Material and methods. Thirty patients with biopsy proven NASH were randomized in a 2:1 fashion to receive 1,200 mg PTX or placebo for 12 months. Metabolic parameters, aminotransferases, liver histology and hepatic gene expression changes were compared. Results. At baseline the groups were similar. Adverse events were mild, most frequently headache and abdominal cramps, and did not differ between groups (p = NS). After 12 months, ALT and AST decreased from 92 ± 12 IU/L to 67 ± 13 IU/L and 67 ± 6 IU/L to 47 ± 6 IU/L (p < 0.05), respectively in patients treated with PTX. No significant effect was seen with placebo. Steatosis and cellular ballooning improved in the PTX group (p < 0.05), whereas no histological feature of steatohepatitis improved with placebo. However, between groups comparison of both biochemical and histological features were nonsignificant. Conclusion. Pentoxifylline is safe, well tolerated and improves transaminases and histology in patients with NASH when compared to baseline and may be a reasonable therapeutic modality for the treatment of NASH. However PTX failed to reduce transaminases compared to placebo and did not positively affect any of the metabolic markers postulated to contribute to NASH. Although animal data and small pilot studies in humans have suggested that PTX may be effective as a treatment for NASH, translating this therapy to clinical practice may prove challenging |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Farmacología, Obesidad, Hígado graso no alcohólico, Cirrosis, Pentoxifilina, Factor de necrosis tumoral |
| Keyword: | Gastroenterology, Pharmacology, Obesity, Non alcoholic fatty liver, Cirrhosis, Pentoxifylline, Tumor necrosis factor |
| Full text: | Texto completo (Ver PDF) |
