AIM OF INVESTIGATION: To compare the effectiveness of different treatment strategies of nonalcoholic fatty liver disease. METHODS:51 patients with nonalcoholic steatohepatitis (NASH) were included in an open randomized prospective comparative study with no control. Patients were divided into 2 groups depending on the chosen treatment strategy. Group 1 (n = 25) had been receiving standard treatment of NASH (Ursodeoxycholic acid 15 mg/kg once a day, per os divided into 3 doses, Atorvastatin 20 mg per os at night, Vitamin E 800 IU/day per os for 12 months); Group 2 (n = 26) had been receiving losartan 50 mg/day per os for 12 months in addition to the above mentioned standard treatment of NASH. STUDY RESULTS: In overall, the results of this work suggest that long-term, for 12 months, losartan usage in a daily dose of 50 mg in the complex therapy of patients with NASH is followed by a significant decrease in the levels of tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) in serum and improvement in 13C-metathetin breath test results. These results indicate a decrease in inflammation and slowing of formation and regression of liver fibrosis. Absence of progress in liver fibrosis in patients on losartan treatment was revealed. CONCLUSIONS: Additional inclusion of losartan in the standard therapy of NASH has a positive therapeutic effect on the process of fibrogenesis in the liver, so it is advisable to appoint losartan in a daily dose of 50 mg for 1 year to these patients.
RCT Entities:
AIM OF INVESTIGATION: To compare the effectiveness of different treatment strategies of nonalcoholic fatty liver disease. METHODS: 51 patients with nonalcoholic steatohepatitis (NASH) were included in an open randomized prospective comparative study with no control. Patients were divided into 2 groups depending on the chosen treatment strategy. Group 1 (n = 25) had been receiving standard treatment of NASH (Ursodeoxycholic acid 15 mg/kg once a day, per os divided into 3 doses, Atorvastatin 20 mg per os at night, Vitamin E 800 IU/day per os for 12 months); Group 2 (n = 26) had been receiving losartan 50 mg/day per os for 12 months in addition to the above mentioned standard treatment of NASH. STUDY RESULTS: In overall, the results of this work suggest that long-term, for 12 months, losartan usage in a daily dose of 50 mg in the complex therapy of patients with NASH is followed by a significant decrease in the levels of tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) in serum and improvement in 13C-metathetin breath test results. These results indicate a decrease in inflammation and slowing of formation and regression of liver fibrosis. Absence of progress in liver fibrosis in patients on losartan treatment was revealed. CONCLUSIONS: Additional inclusion of losartan in the standard therapy of NASH has a positive therapeutic effect on the process of fibrogenesis in the liver, so it is advisable to appoint losartan in a daily dose of 50 mg for 1 year to these patients.