Ezetimibe for the treatment of nonalcoholic fatty liver disease: a meta-analysis.

Nakade Y, Murotani K, Inoue T et al.

Division of Gastroenterology and Hepatology, Department of Internal Medicine.

Hepatology research : the official journal of the Japan Society of Hepatology. Mar 2017.

Several studies on the efficacy of ezetimibe, a potent inhibitor of cholesterol absorption, in treating non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) have been conducted; however, the results are inconsistent. We conducted a meta-analysis to evaluate the efficacy of ezetimibe in treating NAFLD and NASH.Pubmed, Medline, and Cochrane Library Full Text Database were searched until June 2016. The main inclusion criteria included original studies investigating the use of ezetimibe for the treatment of NAFLD and NASH. Literature identification and data extraction were performed by two reviewers based on the inclusion and exclusion criteria. All analyses were performed using Comprehensive Meta-Analysis (CMA) V3 software.An initial search identified 103 peer-reviewed articles and abstracts. Six studies (two randomized-control and four single-arm trials) involving 273 participants with NAFLD and NASH were identified. Ezetimibe significantly reduced serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyl transpeptidase (γ-GTP) levels, and hepatic steatosis and hepatocyte ballooning. However, hepatic inflammation and fibrosis did not improve by ezetimibe treatment in patients with NAFLD and NASH. In randomized-control trials, only hepatocyte ballooning improved by ezetimibe.Although ezetimibe attenuated serum liver enzymes and hepatic steatosis and ballooning in six studies, it improved only hepatocyte ballooning in randomized-control trials. Larger studies and more randomized placebo-controlled trials are necessary to determine the effects of ezetimibe on NAFLD and NASH.


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