Currently, there are no data to support or refute this possibility. The rationale for the clinical use of cholestyramine is mainly based on empirical experience. The only double-blind, randomized
trial with cholestyramine was reported by Di Padova et al.6 more than 25 years ago. This study, which had only 10 participants, found a significant beneficial effect of cholestyramine versus a placebo (P = 0.01). A positive linear relationship between itching and serum bile acids was also demonstrated. Other studies reporting beneficial effects of cholestyramine were not placebo-controlled.5, 20 The scientific basis for the use of cholestyramine as a treatment for cholestatic pruritus is therefore weak at best.21 The present study was the first adequately powered trial evaluating anion-exchange resins in cholestatic pruritus. The click here number of included patients was higher than that
reported by any other comparable trials.10, 11 Furthermore, several complementary methods were used to assess treatment effects, and all analyses revealed consistent results. A weak aspect of the study was the unequal distribution of liver disease etiologies in the treatment BAY 80-6946 groups. This imbalance in etiology was also reflected in the gender distribution. It seems unlikely, however, that these features 上海皓元医药股份有限公司 have significantly influenced the main results of the trial. In conclusion, this randomized, placebo-controlled trial shows that colesevelam is not more effective than a placebo in the treatment of cholestatic pruritus. “
“Nonalcoholic steatohepatitis (NASH), unlike simple steatosis, is a potentially progressive disease. Various types of drugs have been explored for the treatment of NASH. We reviewed the various therapies available, with particular emphasis on their efficacy for the improvement of hepatic fibrosis. Treatments for NASH included lipase-inhibiting agents, drugs that target components of metabolic syndrome, antioxidants,
liver cytoprotectants, and suppressors of inflammatory cytokines. Alanine transaminase levels were significantly decreased and the grade of histologic features other than fibrosis was significantly improved in more than 75% of treatment arms across studies, yet the stage of liver fibrosis was significantly improved in less than 30% of treatment arms. Recently, drugs such as peroxisome proliferator-activated receptor-γ agonists have received attention for their anti-fibrotic effect. However, due to a lack of large-scale, high quality, long-term clinical trials, the utility of any particular treatment for NASH is not yet clear. Further clinical studies are needed to evaluate the efficacy and safety of individual drugs.