Efficacy of pitavastatin for the treatment of non‐alcoholic steatohepatitis with dyslipidemia: An open‐label, pilot study

Hepatology Research - Tập 41 Số 11 - Trang 1057-1065 - 2011
Hideyuki Hyogo1, Tadashi Ikegami2, Katsutoshi Tokushige3, Etsuko Hashimoto3, Kazuo Inui4, Yasushi Matsuzaki2, Hironori Tokumo5, Fumiaki Hino6, Susumu Tazuma7
1Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University
2Division of Gastroenterology and Hepatology, Tokyo Medical University, Ibaraki
3Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo
4Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine, Aichi, Japan
5Department of Gastroenterology and Hepatology, Hiroshima General Hospital
6Department of Gastroenterology and Hepatology, Onomichi General Hospital
7Department of General Medicine, Hiroshima University Graduate School of Medical Science, Programs of Applied Medicine, Clinical Pharmacotherapy, Hiroshima

Tóm tắt

Aim:  Non‐alcoholic fatty liver disease (NAFLD) that encompasses a spectrum of liver disorders characterized by simple steatosis, non‐alcoholic steatohepatitis (NASH) through cirrhosis, is becoming an important chronic liver disease in Japan. Currently, there is no proven therapy for NASH. In this study, we assessed the efficacy of statin therapy in NASH patients with dyslipidemia.

Methods:  Twenty patients with biopsy‐proven NASH with dyslipidemia who agreed to participate in this multicentric prospective study were enrolled. The patients were treated for 12 months with pitavastatin 2 mg/day. Clinical and histological alterations were comparatively evaluated before and after treatment. Standard weight loss counseling was continued during the treatment period. Follow‐up liver biopsy was performed in 13 patients.

Results:  Twenty‐five percent of patients had hyperlipoproteinemia type IIa and 75% had hyperlipoproteinemia type IIb at baseline. The levels of alanine aminotransferase, γ‐glutamyl transpeptidase and lipid profiles were significantly improved by the treatment with pitavastatin for 12 months. Especially, these improvements were prominent in NASH patients with hyperlipoproteinemia type IIb. While non‐alcoholic fatty liver disease activity score and fibrosis stage did not change significantly in all patients, they did improve in 54% and 42% in individual patients, respectively.

Conclusion:  NASH‐related metabolic parameters improved with therapy including histology in some patients. However, three of 13 patients had progression of fibrosis during the treatment. Our pilot study demonstrated the efficacy of pitavastatin for the treatment of NASH with dyslipidemia, especially with hyperlipoproteinemia type IIb and controlled trials are needed in the future.

Từ khóa


Tài liệu tham khảo

10.1002/hep.1840220616

10.1136/gut.2003.019984

10.1016/S0016-5085(99)70506-8

10.1016/S0140-6736(99)00163-4

10.1053/jhep.2002.30692

10.2337/diabetes.50.8.1844

10.1046/j.1440-1746.2003.03170.x

10.1053/jhep.2003.50161

10.1056/NEJMra0912063

10.1002/hep.23314

10.1007/s10620-010-1241-2

10.1007/s00535-010-0311-8

10.1002/hep.23623

10.1038/oby.2006.84

10.1053/gast.2002.36569

10.1111/j.1365-2036.2006.02751.x

10.1002/hep.1840110114

Ludwig J, 1980, Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease, Mayo Clin Proc, 55, 434

10.1155/2003/857869

Hatzitolios A, 2004, Efficacy of omega‐3 fatty acids, atorvastatin and orlistat in non‐alcoholic fatty liver disease with dyslipidemia, Indian J Gastroenterol, 23, 131

10.1016/j.atherosclerosis.2004.01.008

Dohmen K, 2005, Lipoprotein‐lowering drugs for liver disease: fenofibrate being potentially useful as an agent, Prog Med, 25, 103

10.2957/kanzo.46.292

10.1111/j.1365-2036.2006.02926.x

10.1185/030079906X104696

10.1016/j.atherosclerosis.2005.08.021

10.1016/j.metabol.2008.07.030

Mihaila RG, 2009, Effects of lovastatin and pentoxyphyllin in nonalcoholic steatohepatitis, Hepatogastroenterology, 56, 1117

10.1097/MCG.0b013e31819c392e

Abel T, 2009, Safety and efficacy of combined ezetimibe/simvastatin treatment and simvastatin monotherapy in patients with non‐alcoholic fatty liver disease, Med Sci Monit, 15, MS6

10.1007/s00535-010-0203-y

10.1111/j.1872-034X.2010.00644.x

10.1007/s00535-010-0291-8

10.5694/j.1326-5377.1975.tb111524.x

10.1111/j.1440-1746.2007.04943.x

10.1002/hep.1840090504

10.1016/0168-8278(95)80316-5

10.1053/jhep.2003.50193

Matsuzawa Y, 2000, Japanese Society for the Study of Obesity: new criteria of obesity (in Japanese), J Jpn Soc Study Obes, 6, 18

10.1016/S0168-8278(97)80288-7

10.1007/BF00280883

10.1111/j.2040-1124.2010.00074.x

10.2337/dc09-1777

World Health Organization, 2006, Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO / IDF consultation, World Hearth Org

10.1111/j.1572-0241.1999.01377.x

10.1002/hep.20701

10.1016/S1388-1981(01)00201-3

10.1016/S0021-9150(00)00407-X

10.1007/s00535-006-1883-1

10.1074/jbc.R100035200

10.1073/pnas.0830671100

10.1074/jbc.M111041200

10.1074/jbc.M204887200

10.1016/S0092-8674(00)80213-5

10.1097/00041433-199904000-00008

10.1016/j.jhep.2004.09.012

10.1002/hep.21327

10.1016/j.jhep.2009.03.019

10.1136/gut.2009.205088

10.1016/S0140-6736(10)61272-X

10.1053/j.gastro.2009.01.053