Evidence map›Paper›PMID 22050199›Full record

SynthesisAlimentary pharmacology & therapeutics2012

Meta-analysis: pioglitazone improves liver histology and fibrosis in patients with non-alcoholic steatohepatitis.

E Boettcher, G Csako, F Pucino, R Wesley, R Loomba

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Alimentary pharmacology & therapeutics, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 145 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
145citing papers in PubMed, 6 pooled it
9.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

145 citing papers in PubMed, 6 syntheses or guidelines pooled it, 309 citations in OpenAlex.

  1. Pooled it
  2. Impact of DPP-4 Inhibitors on Interleukin Levels in Type 2 Diabetes Mellitus.The Journal of clinical endocrinology and metabolism · 2025
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Effect of weight loss on magnetic resonance imaging estimation of liver fat and volume in patients with nonalcoholic steatohepatitis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2015
    Trial
  10. Article
  11. Review
  12. Review
  13. Article
  14. Review
  15. Review
  16. Article
  17. Review
  18. Review
  19. Article
  20. Review

85 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

E BoettcherDivision of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA 92093, USA.
G Csako
F Pucino
R Wesley
R Loomba
National Institutes of Health Clinical Center · USUniversity of California San Diego · USNational Institute of Diabetes and Digestive and Kidney Diseases · US

Funding

STUDY OF RISK FACTORS FOR OSTEOPOROSIS IN THE ELDERLYR37AG007181 · UNIVERSITY OF CALIFORNIA SAN DIEGO · 1987 to 2005
$2.2M
EPIDEMIOLOGY OF NIDDM AND IGT IN AN ADULT COMMUNITYR01DK031801 · UNIVERSITY OF CALIFORNIA SAN DIEGO · 1986 to 2000
$606k
NIA NIH HHS R01 AG028507NIA NIH HHS R01AG28507NIA NIH HHS R37 AG007181NIA NIH HHS R37AG007181NIDDK NIH HHS DK080506NIDDK NIH HHS K23 DK090303NIDDK NIH HHS R01 DK031801NIDDK NIH HHS R01DK31801NIDDK NIH HHS R24 DK080506
6 · The paper itself

Abstract

backgroundThiazolidinediones (TZDs) have been used in the treatment of non-alcoholic steatohepatitis (NASH). However, the magnitude of treatment response associated with TZDs in improving liver histology in NASH has not been quantified systematically.

aimTo conduct a meta-analysis of randomised, placebo-controlled clinical trials (RPCTs) using pioglitazone and rosiglitazone in the treatment of NASH.

methodsPubmed/MEDLINE and Cochrane Central Register of Controlled Trials 2010 were searched until September 2010 and four RPCTs were identified. Peto odds ratios (ORs) and their respective 95% confidence intervals (CIs) were used to assess the efficacy of TZDs in improving liver histological parameters.

resultsFour good quality RPCTs derived from three continents were included. The meta-analysis showed that TZDs (n = 169) were significantly better than placebo (n = 165) in improving ballooning degeneration, lobular inflammation and steatosis with combined ORs of 2.11 (95% CI, 1.33-3.36), 2.58 (95% CI, 1.68-3.97) and 3.39 (95% CI, 2.19-5.25) respectively. The improvement in combined necroinflammation with TZD (n = 58) vs. placebo (n = 52) was also statistically significant (combined OR 6.52[95% CI, 3.03-14.06]), but improvement in fibrosis was not. When pioglitazone (n = 137) was analysed alone, the improvement in fibrosis with pioglitazone (n = 137) vs. placebo (n = 134) (combined OR 1.68 [95% CI, 1.02-2.77]) was statistically significant. The total body fat slightly decreased in the control, while it markedly and highly significantly increased with TZD treatment.

conclusionsThiazolidinediones significantly improve ballooning degeneration, lobular inflammation, steatosis and combined necroinflammation in patients with NASH. Pioglitazone may improve fibrosis. Larger randomised, placebo-controlled clinical trials are needed to examine the efficacy of thiazolidinediones in improving NASH fibrosis.

Indexed as

Fatty LiverHumansHypoglycemic AgentsLiverLiver CirrhosisNon-alcoholic Fatty Liver DiseasePioglitazoneRandomized Controlled Trials as TopicThiazolidinedionesHypoglycemic AgentsPioglitazoneThiazolidinediones

Identifiers

PMID22050199
PMCPMC3488596
OpenAlexW1868475579

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.