DHA, vitamin E of no benefit in MASLD

In the treatment of adults with metabolic dysfunction–associated steatotic liver disease (MASLD), the use of docosahexaenoic acid (DHA), vitamin E, or its combination stops short of reducing liver fat or aminotransferases, according to a study.

The study included 203 adult patients with MASLD (mean age 51 years, 53 percent female, 91 percent White) who were randomly allocated to one of the following treatment arms: vitamin E 1,000 mg plus DHA 1.89 g (combination), vitamin E 1,000 mg alone, DHA 1.89 g alone, or placebo. Treatment was given daily for 6 months.

Researchers examined the efficacy of the studied treatments in terms of reducing hepatic fat fraction (%) relative to baseline, which was the primary endpoint. They also evaluated the effect on treatment on liver enzymes.

The study did not meet its primary endpoint. Compared with placebo, the combination of DHA plus vitamin E did not produce reductions in hepatic steatosis, which was measured using MRI-proton density fat fraction (p=0.98). Likewise, neither vitamin E alone (p=0.91) nor DHA alone (p=0.14) showed a significant effect of hepatic steatosis as compared with placebo.

However, the researchers acknowledged that their trial was not powered adequately for such analysis.

In terms of the effect on liver enzymes, no statistically significant differences were observed in the 3-month or 6-month levels for alanine transaminase (ALT) or aspartate transaminase (AST) across the DHA, vitamin E, or combination arms vs the placebo arm.