Pharmacological Therapies for Improving Fibrosis in Nonalcoholic Steatohepatitis

Presence of fibrosis is a main predictor of future liver disease–related complications in patients with nonalcoholic steatohepatitis (NASH); however, randomized trials of possible pharmacological therapies have not been designed to detect changes in this outcome.

To compare the efficacies of four pharmacological therapies for improving fibrosis in patients with biopsy-proven NASH, researchers conducted a systematic review with a direct meta-analysis and a Bayesian network meta-analysis (combining direct and indirect evidence), pooling data from nine randomized, controlled trials comprising 964 patients. Therapies studied included vitamin E, thiazolidinediones (TZDs), pentoxifylline (PTX), and obeticholic acid (OCA). Secondary endpoints were …