Randomized controlled studies investigating the effect of ursodeoxycholic acid (UDCA) and vitamin E on nonalcoholic steatohepatitis (NASH) have produced inconsistent results. The long-term tolerability and efficacy of this therapeutic combination were investigated in this study. Subjects included adult patients (n = 101) with persistent elevation of serum aminotransferases (AST and ALT) and/or γ glutamyl-transferase (GGT), in whom a histological diagnosis of NASH was made between 1998 and 2009, and who were treated with a combination of UDCA and vitamin E. UDCA and vitamin E were well tolerated (5% withdrawal for side effects). Mean serum AST, ALT, and GGT levels (expressed as times of Upper Normal Limit) diminished significantly (1.39 ± 0.74 to 0.78 ± 0.34 for AST; 1.72 ± 0.92 to 0.91 ± 0.69 for AST; and 3.25 ± 2.85 to 1.30 ± 1.30 for GGT). AST, ALT, and GGT reached normal range in 80%, 70%, and 65% of the patients, respectively. From the ten patients who had a second liver biopsy during follow-up, NAFLD activity score improved in seven, and worsened in one. The combination of UDCA with vitamin E is well tolerated and seems to improve liver function tests. Clin Res Hepatol Gastroenterol. 2011 Dec 7. PMID: 22154224
