Combined pantethine and probucol therapy for Japanese patients with non-alcoholic steatohepatitis

Aims: To evaluate the efficacy and mechanism of combined pantethine and probucol therapy in Japanese patients with non-alcoholic steatohepatitis (NASH), liver function, serum cytokines, serum adiponectin and liver biopsy findings were investigated. Methods: Sixteen patients with NASH and hyperlipidemia were treated with pantethine (600 mg/day) and probucol (500 mg/day) for 48 weeks. Results: The mean pretreatment aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 66 IU/L and 113 IU/L, respectively, which showed a significant decrease with treatment to 33 IU/L and 51 IU/L (P < 0.01 and P < 0.05), respectively. Total cholesterol was also significantlydecreased (P < 0.01). In addition, the mean serum TGF-beta level was significantly decreased, while the mean serum level of high molecular adiponectin was increased. In eight patients, liver biopsy was performed both before and after treatment. In four of these patients, inflammation was improved, and fibrosis was improved in two patients. No side-effects of this treatment were noted. Conclusion: Combined pantethine and probucol therapy was safe and effective for Japanese NASH patients, with its efficacy being mediated through adiponectin and TGF-beta.