Effects of pentoxifylline on nonalcoholic fatty liver disease: a meta-analysis

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: Meta-analysis; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Pentoxifylline.

Figure 1

Selection of studies.

Figure 2

Forest plot of the effects of probiotics in patients with nonalcoholic fatty liver disease. BMI: Body mass index; ALT: Alanine aminotransferase; AST: Aspartate transaminase; UDCA: Ursodeoxycholic acid; TC: Total cholesterol; TG: Triglyceride; AKP: Alkaline phosphatase; GGT: γ-glutamyl transferase; GLU: Glucose; TNF-α: Tumor necrosis factor-α; IL: Interleukin; NAS: NAFLD activity score.