Nonalcoholic steatohepatitis (NASH) is a frequent liver disease that can progress to cirrhosis and for which effective therapy is still lacking. Despitean important role of oxidative stress in the pathogenesis of NASH, antioxidant approaches have not been investigatedsufficiently. The aim of the study was to compare the efficacy of ursodeoxycholic acid (UDCA) versus vitamin E plus vitamin C in non-diabetic patients with nonalcoholic steatohepatitis. Patients with elevated aminotransferase levels and drinking, less than 40 g alcohol/week with NASH diagnose were randomly assigned to receive either UDCA 15 mg/per kg/day (group A) or vitamin E 800mg/day plus vitamin C 500 mg/day (group B) for 12 months and control group,which did not receive any medical treatment. Lifestyle modification was advised to all groups. The primary study endpoint was improvement in alanine transaminase (ALT) levels, secondary endpoints were improvement in steatosis score and improvement in fibrosis score. Baseline characteristics were not significantly different between groups. After 12 months treatment with vitamin E plus C, as compared with UDCA, was associated with a significant reduction ofmean alanineaminotransferase (ALT) levels. Similarly, there was significant reduction of both mean steatosis score and fibrosis score. Vitamin E plus C combination is aneffective, safe and inexpensive treatmentoption in patients with NASHand may be useful to reduce damage from oxidative stress and slow the process leading to cirrhosis.
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