Meta-Analysis
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 14, 2014; 20(2): 569-577
Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.569
Effects of pentoxifylline on nonalcoholic fatty liver disease: A meta-analysis
Juan Du, Yan-Yan Ma, Chao-Hui Yu, You-Ming Li
Juan Du, Yan-Yan Ma, Chao-Hui Yu, You-Ming Li, Department of Gastroenterology, The First Affiliated Hospital, Medical School, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Li YM proposed the study and revised the manuscript; Du J and Ma YY designed study, analyzed the data and wrote the manuscript; Yu CH contributed to the discussion; all the authors have read and approved the final version to be published.
Supported by Zhejiang Provincial Natural Science Foundation of China, No. LQ13H030002; Medical and Health Science Fund of Health Bureau of Zhejiang Province, China, No. 2013KYB089
Correspondence to: You-Ming Li, MD, Department of Gastroenterology, The First Affiliated Hospital, Medical School, Zhejiang University, Hangzhou 310003, Zhejiang Province, China. zlym@zju.edu.cn
Telephone: +86-571-87236603 Fax: +86-571-87236611
Received: August 8, 2013
Revised: September 20, 2013
Accepted: October 17, 2013
Published online: January 14, 2014
Abstract

AIM: To evaluate the effects of pentoxifylline therapy in patients with nonalcoholic fatty liver disease (NAFLD).

METHODS: We searched PubMed, Medline, Google Scholar, Embase, Web of Science, the Cochrane Library and the Chinese Biomedicine Database for all relevant controlled trials of pentoxifylline in patients with NAFLD from 1997 to July 2013. Five studies (3 randomized, double-blind, placebo-controlled trials and 2 prospective cohort studies with concurrent controls) were included in this meta-analysis. Statistical analysis was performed using RevMan 5.0 software.

RESULTS: Five randomized trials of 147 patients with NAFLD/nonalcoholic steatohepatitis (NASH) were included. The results showed that compared to placebo, pentoxifylline therapy resulted in a significant decrease in body weight (P = 0.04), alanine aminotransferase (P < 0.00001), aspartate transaminase (P = 0.0006), glucose (P = 0.0008) and tumor necrosis factor-α (P = 0.007), but did not significantly affect body mass index (P = 0.28), total cholesterol (P = 0.80), triglyceride (P = 0.98), alkaline phosphatase (P = 0.29), γ-glutamyl transferase (P = 0.39) and interleukin-6 (P = 0.38). With regard to histological changes, pentoxifylline only reduced the NAFLD activity score (P < 0.00001) and improved lobular inflammation (P < 0.0001). Improvements in steatosis grade (P = 0.11), ballooning (P = 0.10) and fibrosis (P = 0.50) were not obvious.

CONCLUSION: Pentoxifylline therapy results in weight loss, improved liver function and histological changes in patients with NAFLD/NASH. Therefore, pentoxifylline may be a new treatment option for NAFLD.

Keywords: Pentoxifylline, Nonalcoholic fatty liver disease, Nonalcoholic steatohepatitis, Meta-analysis

Core tip: Recently, more researchers have been attempting to identify new treatments for nonalcoholic fatty liver disease (NAFLD), however, no firm conclusions have been reached. Thus, it is necessary to conduct a meta-analysis to assess the efficacy of pentoxifylline. Our analysis showed that pentoxifylline therapy significantly decreased body weight, alanine aminotransferase, aspartate transaminase, glucose and tumor necrosis factor-α. Pentoxifylline also reduced the NAFLD activity score and improved lobular inflammation in NAFLD patients.