First-in-Asian double-blind randomized trial to assess the efficacy and safety of insulin sensitizer in nonalcoholic steatohepatitis patients
Background The efficacy and safety of insulin sensitizer in Asians with non-alcoholic steatohepatitis (NASH) remain elusive. Aims The double-blind, randomized, placebo-controlled trial was conducted aiming to investigate the efficacy and safety of pioglitazone in NASH patients. Methods A total of 90...
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| Veröffentlicht in: | Hepatology international 2021-10, Vol.15 (5), p.1136-1147 |
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| creator | Huang, Jee-Fu Dai, Chia-Yen Huang, Chung-Feng Tsai, Pei-Chien Yeh, Ming-Lun Hsu, Po-Yau Huang, Shiu-Feng Bair, Ming-Jong Hou, Nai-Jen Huang, Ching-I Liang, Po-Cheng Lin, Yi-Hung Wang, Chih-Wen Hsieh, Ming-Yen Chen, Shinn-Chern Lin, Zu-Yau Yu, Ming-Lung Chuang, Wan-Long |
| description | Background
The efficacy and safety of insulin sensitizer in Asians with non-alcoholic steatohepatitis (NASH) remain elusive.
Aims
The double-blind, randomized, placebo-controlled trial was conducted aiming to investigate the efficacy and safety of pioglitazone in NASH patients.
Methods
A total of 90 NASH patients (66 males, age = 44.1 ± 12.7 years) were prospectively randomized into oral pioglitazone 30 mg/day (Arm A) or placebo (Arm B) for 24 weeks. The primary endpoint was the efficacy of pioglitazone in reducing inflammation and liver fat at end-of-treatment (EOT). NASH resolution/improvement without fibrosis worsening was also evaluated.
Results
At EOT, there was a significantly decline of alanine aminotransferase (86.9 ± 34.3 to 45.7 ± 35.8 IU/L,
p
= 0.003) level in Arm A patients. In intention-to-treat analysis among 66 patients who completed paired biopsies, The NAFLD activity score (NAS) of 30 Arm A patients significantly decreased from 4.27 ± 1.14 at baseline to 2.53 ± 1.63 at EOT (
p
|
| doi_str_mv | 10.1007/s12072-021-10242-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2561482823</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2581838069</sourcerecordid><originalsourceid>FETCH-LOGICAL-c485t-c02635c398611ffe034e30f09f880dd0641a6c0e3af4fcaefa758edc3466ad973</originalsourceid><addsrcrecordid>eNp9kb1uVDEQhS1ERMLCC1AgSzQ0Bv9dr28ZRSQgRaKB-sprj1lHd-3F41ss78A7480mQaKgmtH4O2fkOYS8EfyD4Hz9EYXka8m4FExwqSWTz8iFGJVhfNDi-VOv1Dl5iXjH-TAYYV6Qc6WVNaMaLsjv61SxsZTZJSaXaSjLZga2mVMOtLocyi79gkBbTW6mrVCHCIi0bYFCjMk7f6Ado-gitAMtkaaMS5dThIypdXXtI5pLdrMv2zInT7GBa2ULe9c6gfRYITd8Rc6imxFeP9QV-X796dvVZ3b79ebL1eUt89oOjXkujRq8Gq0RIkbgSoPikY_RWh4CN1o44zkoF3X0DqJbDxaCV9oYF8a1WpH3J999LT8XwDbtEnqYZ5ehLDjJfidtpZWqo-_-Qe_KUvtfjpQVVlneL7ki8kT5WhArxGlf087VwyT4dAxrOoU19bCm-7Am2UVvH6yXzQ7Ck-QxnQ6oE4D9Kf-A-nf3f2z_ALBNojU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2581838069</pqid></control><display><type>article</type><title>First-in-Asian double-blind randomized trial to assess the efficacy and safety of insulin sensitizer in nonalcoholic steatohepatitis patients</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Huang, Jee-Fu ; Dai, Chia-Yen ; Huang, Chung-Feng ; Tsai, Pei-Chien ; Yeh, Ming-Lun ; Hsu, Po-Yau ; Huang, Shiu-Feng ; Bair, Ming-Jong ; Hou, Nai-Jen ; Huang, Ching-I ; Liang, Po-Cheng ; Lin, Yi-Hung ; Wang, Chih-Wen ; Hsieh, Ming-Yen ; Chen, Shinn-Chern ; Lin, Zu-Yau ; Yu, Ming-Lung ; Chuang, Wan-Long</creator><creatorcontrib>Huang, Jee-Fu ; Dai, Chia-Yen ; Huang, Chung-Feng ; Tsai, Pei-Chien ; Yeh, Ming-Lun ; Hsu, Po-Yau ; Huang, Shiu-Feng ; Bair, Ming-Jong ; Hou, Nai-Jen ; Huang, Ching-I ; Liang, Po-Cheng ; Lin, Yi-Hung ; Wang, Chih-Wen ; Hsieh, Ming-Yen ; Chen, Shinn-Chern ; Lin, Zu-Yau ; Yu, Ming-Lung ; Chuang, Wan-Long</creatorcontrib><description>Background
The efficacy and safety of insulin sensitizer in Asians with non-alcoholic steatohepatitis (NASH) remain elusive.
Aims
The double-blind, randomized, placebo-controlled trial was conducted aiming to investigate the efficacy and safety of pioglitazone in NASH patients.
Methods
A total of 90 NASH patients (66 males, age = 44.1 ± 12.7 years) were prospectively randomized into oral pioglitazone 30 mg/day (Arm A) or placebo (Arm B) for 24 weeks. The primary endpoint was the efficacy of pioglitazone in reducing inflammation and liver fat at end-of-treatment (EOT). NASH resolution/improvement without fibrosis worsening was also evaluated.
Results
At EOT, there was a significantly decline of alanine aminotransferase (86.9 ± 34.3 to 45.7 ± 35.8 IU/L,
p
= 0.003) level in Arm A patients. In intention-to-treat analysis among 66 patients who completed paired biopsies, The NAFLD activity score (NAS) of 30 Arm A patients significantly decreased from 4.27 ± 1.14 at baseline to 2.53 ± 1.63 at EOT (
p
< 0.0001), whereas there was no significant change in patients of Arm B (3.94 ± 1.41 vs 3.94 ± 1.51,
p
= 1.0). NASH improvement without worsening of fibrosis was achieved in 46.7% (14/30) patients in Arm A, compared to 11.1% (4/36) patients in Arm B (
p
= 0.002). Liver fat content reduced (20.2 ± 9.0 to 14.3 ± 6.9%,
p
< 0.0001) on MRI–PDFF in Arm A compared to their counterparts. No significant difference of adverse events occurred between groups.
Conclusions
A 24-week pioglitazone treatment was well-tolerated and effective in improving liver histology and reducing liver steatosis in Asian NASH patients. (ClinicalTrials.gov number: NCT01068444)</description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-021-10242-2</identifier><identifier>PMID: 34386935</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Adult ; Adverse events ; Alanine ; Alanine transaminase ; Asians ; Biopsy ; Colorectal Surgery ; Double-Blind Method ; Double-blind studies ; Fatty liver ; Female ; Fibrosis ; Hepatology ; Histology ; Humans ; Insulin ; Insulin resistance ; Liver ; Magnetic resonance imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; NCT ; NCT01068444 ; Non-alcoholic Fatty Liver Disease - drug therapy ; Original Article ; Patients ; Pioglitazone ; Placebos ; Safety ; Steatosis ; Surgery ; Treatment Outcome</subject><ispartof>Hepatology international, 2021-10, Vol.15 (5), p.1136-1147</ispartof><rights>Asian Pacific Association for the Study of the Liver 2021</rights><rights>2021. Asian Pacific Association for the Study of the Liver.</rights><rights>Asian Pacific Association for the Study of the Liver 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-c02635c398611ffe034e30f09f880dd0641a6c0e3af4fcaefa758edc3466ad973</citedby><cites>FETCH-LOGICAL-c485t-c02635c398611ffe034e30f09f880dd0641a6c0e3af4fcaefa758edc3466ad973</cites><orcidid>0000-0002-2752-7051</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12072-021-10242-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12072-021-10242-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34386935$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Jee-Fu</creatorcontrib><creatorcontrib>Dai, Chia-Yen</creatorcontrib><creatorcontrib>Huang, Chung-Feng</creatorcontrib><creatorcontrib>Tsai, Pei-Chien</creatorcontrib><creatorcontrib>Yeh, Ming-Lun</creatorcontrib><creatorcontrib>Hsu, Po-Yau</creatorcontrib><creatorcontrib>Huang, Shiu-Feng</creatorcontrib><creatorcontrib>Bair, Ming-Jong</creatorcontrib><creatorcontrib>Hou, Nai-Jen</creatorcontrib><creatorcontrib>Huang, Ching-I</creatorcontrib><creatorcontrib>Liang, Po-Cheng</creatorcontrib><creatorcontrib>Lin, Yi-Hung</creatorcontrib><creatorcontrib>Wang, Chih-Wen</creatorcontrib><creatorcontrib>Hsieh, Ming-Yen</creatorcontrib><creatorcontrib>Chen, Shinn-Chern</creatorcontrib><creatorcontrib>Lin, Zu-Yau</creatorcontrib><creatorcontrib>Yu, Ming-Lung</creatorcontrib><creatorcontrib>Chuang, Wan-Long</creatorcontrib><title>First-in-Asian double-blind randomized trial to assess the efficacy and safety of insulin sensitizer in nonalcoholic steatohepatitis patients</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><addtitle>Hepatol Int</addtitle><description>Background
The efficacy and safety of insulin sensitizer in Asians with non-alcoholic steatohepatitis (NASH) remain elusive.
Aims
The double-blind, randomized, placebo-controlled trial was conducted aiming to investigate the efficacy and safety of pioglitazone in NASH patients.
Methods
A total of 90 NASH patients (66 males, age = 44.1 ± 12.7 years) were prospectively randomized into oral pioglitazone 30 mg/day (Arm A) or placebo (Arm B) for 24 weeks. The primary endpoint was the efficacy of pioglitazone in reducing inflammation and liver fat at end-of-treatment (EOT). NASH resolution/improvement without fibrosis worsening was also evaluated.
Results
At EOT, there was a significantly decline of alanine aminotransferase (86.9 ± 34.3 to 45.7 ± 35.8 IU/L,
p
= 0.003) level in Arm A patients. In intention-to-treat analysis among 66 patients who completed paired biopsies, The NAFLD activity score (NAS) of 30 Arm A patients significantly decreased from 4.27 ± 1.14 at baseline to 2.53 ± 1.63 at EOT (
p
< 0.0001), whereas there was no significant change in patients of Arm B (3.94 ± 1.41 vs 3.94 ± 1.51,
p
= 1.0). NASH improvement without worsening of fibrosis was achieved in 46.7% (14/30) patients in Arm A, compared to 11.1% (4/36) patients in Arm B (
p
= 0.002). Liver fat content reduced (20.2 ± 9.0 to 14.3 ± 6.9%,
p
< 0.0001) on MRI–PDFF in Arm A compared to their counterparts. No significant difference of adverse events occurred between groups.
Conclusions
A 24-week pioglitazone treatment was well-tolerated and effective in improving liver histology and reducing liver steatosis in Asian NASH patients. (ClinicalTrials.gov number: NCT01068444)</description><subject>Adult</subject><subject>Adverse events</subject><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>Asians</subject><subject>Biopsy</subject><subject>Colorectal Surgery</subject><subject>Double-Blind Method</subject><subject>Double-blind studies</subject><subject>Fatty liver</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Hepatology</subject><subject>Histology</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Liver</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>NCT</subject><subject>NCT01068444</subject><subject>Non-alcoholic Fatty Liver Disease - drug therapy</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pioglitazone</subject><subject>Placebos</subject><subject>Safety</subject><subject>Steatosis</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kb1uVDEQhS1ERMLCC1AgSzQ0Bv9dr28ZRSQgRaKB-sprj1lHd-3F41ss78A7480mQaKgmtH4O2fkOYS8EfyD4Hz9EYXka8m4FExwqSWTz8iFGJVhfNDi-VOv1Dl5iXjH-TAYYV6Qc6WVNaMaLsjv61SxsZTZJSaXaSjLZga2mVMOtLocyi79gkBbTW6mrVCHCIi0bYFCjMk7f6Ado-gitAMtkaaMS5dThIypdXXtI5pLdrMv2zInT7GBa2ULe9c6gfRYITd8Rc6imxFeP9QV-X796dvVZ3b79ebL1eUt89oOjXkujRq8Gq0RIkbgSoPikY_RWh4CN1o44zkoF3X0DqJbDxaCV9oYF8a1WpH3J999LT8XwDbtEnqYZ5ehLDjJfidtpZWqo-_-Qe_KUvtfjpQVVlneL7ki8kT5WhArxGlf087VwyT4dAxrOoU19bCm-7Am2UVvH6yXzQ7Ck-QxnQ6oE4D9Kf-A-nf3f2z_ALBNojU</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Huang, Jee-Fu</creator><creator>Dai, Chia-Yen</creator><creator>Huang, Chung-Feng</creator><creator>Tsai, Pei-Chien</creator><creator>Yeh, Ming-Lun</creator><creator>Hsu, Po-Yau</creator><creator>Huang, Shiu-Feng</creator><creator>Bair, Ming-Jong</creator><creator>Hou, Nai-Jen</creator><creator>Huang, Ching-I</creator><creator>Liang, Po-Cheng</creator><creator>Lin, Yi-Hung</creator><creator>Wang, Chih-Wen</creator><creator>Hsieh, Ming-Yen</creator><creator>Chen, Shinn-Chern</creator><creator>Lin, Zu-Yau</creator><creator>Yu, Ming-Lung</creator><creator>Chuang, Wan-Long</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2752-7051</orcidid></search><sort><creationdate>20211001</creationdate><title>First-in-Asian double-blind randomized trial to assess the efficacy and safety of insulin sensitizer in nonalcoholic steatohepatitis patients</title><author>Huang, Jee-Fu ; Dai, Chia-Yen ; Huang, Chung-Feng ; Tsai, Pei-Chien ; Yeh, Ming-Lun ; Hsu, Po-Yau ; Huang, Shiu-Feng ; Bair, Ming-Jong ; Hou, Nai-Jen ; Huang, Ching-I ; Liang, Po-Cheng ; Lin, Yi-Hung ; Wang, Chih-Wen ; Hsieh, Ming-Yen ; Chen, Shinn-Chern ; Lin, Zu-Yau ; Yu, Ming-Lung ; Chuang, Wan-Long</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-c02635c398611ffe034e30f09f880dd0641a6c0e3af4fcaefa758edc3466ad973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Adverse events</topic><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>Asians</topic><topic>Biopsy</topic><topic>Colorectal Surgery</topic><topic>Double-Blind Method</topic><topic>Double-blind studies</topic><topic>Fatty liver</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Hepatology</topic><topic>Histology</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Liver</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>NCT</topic><topic>NCT01068444</topic><topic>Non-alcoholic Fatty Liver Disease - drug therapy</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pioglitazone</topic><topic>Placebos</topic><topic>Safety</topic><topic>Steatosis</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Jee-Fu</creatorcontrib><creatorcontrib>Dai, Chia-Yen</creatorcontrib><creatorcontrib>Huang, Chung-Feng</creatorcontrib><creatorcontrib>Tsai, Pei-Chien</creatorcontrib><creatorcontrib>Yeh, Ming-Lun</creatorcontrib><creatorcontrib>Hsu, Po-Yau</creatorcontrib><creatorcontrib>Huang, Shiu-Feng</creatorcontrib><creatorcontrib>Bair, Ming-Jong</creatorcontrib><creatorcontrib>Hou, Nai-Jen</creatorcontrib><creatorcontrib>Huang, Ching-I</creatorcontrib><creatorcontrib>Liang, Po-Cheng</creatorcontrib><creatorcontrib>Lin, Yi-Hung</creatorcontrib><creatorcontrib>Wang, Chih-Wen</creatorcontrib><creatorcontrib>Hsieh, Ming-Yen</creatorcontrib><creatorcontrib>Chen, Shinn-Chern</creatorcontrib><creatorcontrib>Lin, Zu-Yau</creatorcontrib><creatorcontrib>Yu, Ming-Lung</creatorcontrib><creatorcontrib>Chuang, Wan-Long</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Jee-Fu</au><au>Dai, Chia-Yen</au><au>Huang, Chung-Feng</au><au>Tsai, Pei-Chien</au><au>Yeh, Ming-Lun</au><au>Hsu, Po-Yau</au><au>Huang, Shiu-Feng</au><au>Bair, Ming-Jong</au><au>Hou, Nai-Jen</au><au>Huang, Ching-I</au><au>Liang, Po-Cheng</au><au>Lin, Yi-Hung</au><au>Wang, Chih-Wen</au><au>Hsieh, Ming-Yen</au><au>Chen, Shinn-Chern</au><au>Lin, Zu-Yau</au><au>Yu, Ming-Lung</au><au>Chuang, Wan-Long</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>First-in-Asian double-blind randomized trial to assess the efficacy and safety of insulin sensitizer in nonalcoholic steatohepatitis patients</atitle><jtitle>Hepatology international</jtitle><stitle>Hepatol Int</stitle><addtitle>Hepatol Int</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>15</volume><issue>5</issue><spage>1136</spage><epage>1147</epage><pages>1136-1147</pages><issn>1936-0533</issn><eissn>1936-0541</eissn><abstract>Background
The efficacy and safety of insulin sensitizer in Asians with non-alcoholic steatohepatitis (NASH) remain elusive.
Aims
The double-blind, randomized, placebo-controlled trial was conducted aiming to investigate the efficacy and safety of pioglitazone in NASH patients.
Methods
A total of 90 NASH patients (66 males, age = 44.1 ± 12.7 years) were prospectively randomized into oral pioglitazone 30 mg/day (Arm A) or placebo (Arm B) for 24 weeks. The primary endpoint was the efficacy of pioglitazone in reducing inflammation and liver fat at end-of-treatment (EOT). NASH resolution/improvement without fibrosis worsening was also evaluated.
Results
At EOT, there was a significantly decline of alanine aminotransferase (86.9 ± 34.3 to 45.7 ± 35.8 IU/L,
p
= 0.003) level in Arm A patients. In intention-to-treat analysis among 66 patients who completed paired biopsies, The NAFLD activity score (NAS) of 30 Arm A patients significantly decreased from 4.27 ± 1.14 at baseline to 2.53 ± 1.63 at EOT (
p
< 0.0001), whereas there was no significant change in patients of Arm B (3.94 ± 1.41 vs 3.94 ± 1.51,
p
= 1.0). NASH improvement without worsening of fibrosis was achieved in 46.7% (14/30) patients in Arm A, compared to 11.1% (4/36) patients in Arm B (
p
= 0.002). Liver fat content reduced (20.2 ± 9.0 to 14.3 ± 6.9%,
p
< 0.0001) on MRI–PDFF in Arm A compared to their counterparts. No significant difference of adverse events occurred between groups.
Conclusions
A 24-week pioglitazone treatment was well-tolerated and effective in improving liver histology and reducing liver steatosis in Asian NASH patients. (ClinicalTrials.gov number: NCT01068444)</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>34386935</pmid><doi>10.1007/s12072-021-10242-2</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-2752-7051</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1936-0533 |
| ispartof | Hepatology international, 2021-10, Vol.15 (5), p.1136-1147 |
| issn | 1936-0533 1936-0541 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Adverse events Alanine Alanine transaminase Asians Biopsy Colorectal Surgery Double-Blind Method Double-blind studies Fatty liver Female Fibrosis Hepatology Histology Humans Insulin Insulin resistance Liver Magnetic resonance imaging Male Medicine Medicine & Public Health Middle Aged NCT NCT01068444 Non-alcoholic Fatty Liver Disease - drug therapy Original Article Patients Pioglitazone Placebos Safety Steatosis Surgery Treatment Outcome |
| title | First-in-Asian double-blind randomized trial to assess the efficacy and safety of insulin sensitizer in nonalcoholic steatohepatitis patients |
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