Table 2.

Summary of medication intervention studies

Ref.	Population, Study Design	Intervention	Results
[79]	n = 15, open label study with histologically confirmed NAFLD adults	All patients received 20 mg/kg per day of metformin for 48 wk	In the initial 3 mo there was improvement in ALT and AST levels and insulin sensitivity, after 3 mo no further improvement noted
[80]	n = 57 24-mo observational study with NAFLD or NASH overweight and obese children	Metformin was progressively titrated from 250-500 mg tid at weekly intervals and patients were given a hypocaloric or isocaloric diet and recommended to engage in 45 min/d of physical activity (n = 57) compared to control group (n = 30) with the same diet and physical activity recommendations	ALT significantly improved with decreasing body weight. NAS score decreased in both groups, no significant changes in fibrosis
[85]	n = 63, randomized, double-blind placebo – controlled in NASH adults	32 patients were given rosiglitazone (4 mg/d for 1 mo then 8 mg/d for 11 mo) vs placebo (n = 31)	Improved steatosis and normalized transaminase, only ½ responded. Improvement of insulin sensitivity
[86]	n = 47, randomized control study in adults with impaired glucose tolerance or type 2 diabetes with NASH	6 mo of hypocaloric diet and 45 mg (n = 26) of pioglitazone vs 6 mo of hypocaloric diet (n = 21)	Diet and pioglitazone improved glucose tolerance and normalized ALT. Histologic features of NASH improved, no significant reduction in fibrosis
[87]	n = 13 patient cohort with NASH adults	All were treated with 30 mg/d of pioglitazone for 48 wk, than followed up 48 wk after stopping pioglitazone.	Stopping pioglitazone increased ALT, decreased adiponectin, worsened insulin sensitivity and increased hepatic fat, no change in fibrosis
[89]	n = 247, randomization of adults with NASH without diabetes	96 wk of either 30 mg pioglitazone (n = 80), vitamin E (800 IU/d) (n = 84) or placebo (n = 83)	Vitamin E significantly improved NASH. AST and ALT significantly improved in vitamin E and pioglitazone groups, and reduction in hepatic steatosis with no improvement in fibrosis score.
[90]	n = 45 prospective, double-blind randomized, placebo controlled trial in NASH adults	Received vitamin E and C (1000 IU and 1000 mg) (n = 23) or placebo for 6 mo (n = 22) additionally patients received weight loss counselling and encouraged to follow a low fat diet	Vitamin treatment significantly improved fibrosis score

NAFLD: Non-alcoholic fatty liver disease; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; tid: Three times a day; NASH: Nonalcoholic steatohepatitis.