Premium
Beneficial effects of pentoxifylline on hepatic steatosis, fibrosis and necroinflammation in patients with non‐alcoholic steatohepatitis
Author(s) -
Satapathy Sanjaya K,
Sakhuja Puja,
Malhotra Veena,
Sharma Barjesh C,
Sarin Shiv K
Publication year - 2007
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04756.x
Subject(s) - pentoxifylline , medicine , steatohepatitis , steatosis , gastroenterology , fibrosis , liver biopsy , fatty liver , alanine aminotransferase , biopsy , pathology , disease
Background and Aim: Inhibition of tumor necrosis factor (TNF)‐α is a logical approach to manage patients with non‐alcoholic steatohepatitis (NASH). Pentoxifylline reduces TNF‐α and alanine aminotransferase (ALT) levels in patients with NASH. The aim of the present paper was to study if pentoxifylline can improve histological injury in patients with NASH. Methods: Nine patients (mean age 31.6 ± 7.2 years) with histologically proven NASH and with persistently elevated ALT (>1.5 times) were given pentoxyfylline at a dosage of 400 mg t.i.d. for 12 months. Besides biochemical assessment, a repeat liver biopsy was performed and the degree of inflammation and fibrosis was compared. Results: After 12 months of therapy a significant reduction in ALT (111 ± 53 IU/L vs 45 ± 19 IU/L, P = 0.003) and aspartate aminotransferase (AST) (61 ± 27 IU/L vs 33 ± 12 IU/L, P = 0.005) levels was observed. Steatosis and lobular inflammation each reduced in 55% and six (67%) patients down‐staged on Brunt's staging ( P = 0.009). Four out of six patients with baseline fibrosis had reduction in their fibrosis stage. Conclusions: Long‐term pentoxyfylline therapy effectively achieves sustained biochemical improvement. This correlates well with histological resolution of the disease.