Vitamin E or pioglitazone for non-alcoholic steatohepatitis (PIVENS)
The question: Can an antioxidant vitamin help fatty liver?
- Study type
- Randomised controlled trial
- Participants
- 247
- Population
- Adults without diabetes with biopsy-confirmed NASH, multicentre in the United States
- Intervention
- Vitamin E 800 IU daily, or pioglitazone 30 mg daily
- Compared with
- Placebo
- Duration
- 96 weeks
- Published
- New England Journal of Medicine, 2010
What was measured
Composite improvement in liver histology.
What was found
43 per cent of people taking vitamin E met the primary outcome compared with 19 per cent on placebo. Pioglitazone improved several features but did not reach significance on the primary outcome.
Limitations
People with diabetes were excluded, the dose was high and the trial lasted two years, so long-term benefit and risk remain uncertain.
What it means
A landmark trial showing that a nutrient at therapeutic dose can change liver histology. It applies to the dose and population studied, and decisions belong with a doctor.
Source
Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med. 2010;362(18):1675-1685.
Read the original (DOI 10.1056/NEJMoa0907929) · Source verified 8 October 2026
Study summaries describe published research for education. They are not claims about any product and are not medical advice.