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Nonalcoholic steatohepatitis (NASH) is recognized increasingly not just as a histologic curiosity but as a clinically important condition. Thiazoladinediones (e.g., pioglitazone, rosiglitazone), which are approved to treat diabetes, improve liver histology in diabetic patients with NASH (JW Dec 13 2006). But, do nondiabetic patients also show improvement?
U.K. researchers randomized 74 nondiabetic patients with biopsy-proven NASH to receive either pioglitazone (30 mg daily) or placebo; 61 completed the study. At 1 year, when all patients underwent follow-up liver biopsies, patients in the pioglitazone group had significantly lower hepatocyte injury scores than did patients in the placebo group. In the placebo group (30 patients), hepatic fib…