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Vitamin E has shown some benefit for treating nonalcoholic steatohepatitis (NASH) in patients without type 2 diabetes mellitus (T2DM), but there are few data from patients with T2DM. Also, there is growing evidence that T2DM confers an added risk for cirrhosis and hepatocellular carcinoma in patients with NASH (NEJM JW Gastroenterol Jul 2019 and Clin Gastroenterol Hepatol 2019 Apr 19 [e-pub]).
In an investigator-initiated, double-blind study, researchers evaluated the safety and efficacy of vitamin E alone or in combination with pioglitazone in 105 patients with NASH and T2DM recruited at two Veterans Affairs medical centers. Patients were randomized in a 1:1:1 fashion to receive vitamin E 400 IU twice daily, vitamin E plus pioglitazone (sta…