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

Hideyuki Hyogo; Tadashi Ikegami; Katsutoshi Tokushige; Etsuko Hashimoto; Kazuo Inui; Yasushi Matsuzaki; Hironori Tokumo; Fumiaki Hino; Susumu Tazuma

doi:10.1111/j.1872-034X.2011.00849.x

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

Hepatol Res. 2011 Nov;41(11):1057-65. doi: 10.1111/j.1872-034X.2011.00849.x. Epub 2011 Sep 22.

Authors

Hideyuki Hyogo¹, Tadashi Ikegami, Katsutoshi Tokushige, Etsuko Hashimoto, Kazuo Inui, Yasushi Matsuzaki, Hironori Tokumo, Fumiaki Hino, Susumu Tazuma

Affiliation

¹ Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University Department of Gastroenterology and Hepatology, Hiroshima General Hospital Department of Gastroenterology and Hepatology, Onomichi General Hospital Department of General Medicine, Hiroshima University Graduate School of Medical Science, Programs of Applied Medicine, Clinical Pharmacotherapy, Hiroshima Division of Gastroenterology and Hepatology, Tokyo Medical University, Ibaraki Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo Department of Internal Medicine, Second Teaching Hospital, Fujita Health University School of Medicine, Aichi, Japan.

PMID: 21951922
DOI: 10.1111/j.1872-034X.2011.00849.x

Abstract

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.