Ursodeoxycholic acid with vitamin E in patients with nonalcoholic steatohepatitis: long-term results

Clin Res Hepatol Gastroenterol. 2012 Apr;36(2):146-55. doi: 10.1016/j.clinre.2011.10.011. Epub 2011 Dec 8.


Background: The combination of ursodeoxycholic acid (UDCA) and vitamin E is a therapeutic option for nonalcoholic steatohepatitis (NASH) but randomized controlled studies have produced inconsistent results. The objective of this study was to report the long-term tolerability and efficacy of this combination in our ten-year single center experience.

Methods: The study group included 101 adult patients with persistent elevation of serum aminotransferases (AST and ALT) and/or γ glutamyl-transferase (GGT), in whom a histological diagnosis of NASH was made from January 1998 to January 2009, and who were treated with a combination of UDCA with vitamin E.

Results: Median body mass index (30 kg/m(2)) remained unchanged during the study. 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, NAS score improved in seven, and worsened in one.

Conclusions: The combination of UDCA with vitamin E significantly improves liver function tests in long-term and is very well tolerated.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Drug Therapy, Combination
  • Fatty Liver / drug therapy*
  • Humans
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Ursodeoxycholic Acid / therapeutic use*
  • Vitamin E / therapeutic use*
  • Vitamins / therapeutic use*
  • Young Adult


  • Vitamins
  • Vitamin E
  • Ursodeoxycholic Acid