Polyunsaturated phosphatidylcholine (Essentiale) for alcoholic/fatty liver:A systematic review

Objective To evaluate the efficacy and safety of Polyunsaturated phosphatidylcholine (PPC) for alcoholic/fatty liver. Methods Randomized controlled trials comparing PPC versus placebo/no treatment for alcoholic/fatty liver were identified by electronic and manual searches. No blinding、language and publishing were applied. The methodological quality of trials was assessed in four aspect: generation of the allocation sequence、allocation concealment、blinding and follow-up. Two reviewers independently assessed the methodological quality and extracted data on patients、methods、interventions and outcomes. All the data was analyzed by the software of RevMan 4.2 supplied by the Cochrane Collaboration.Results Six trials involving 662 patients were included. The methodological quality was high in six randomized controlled trials. No serious adverse events were reported. One study involving 102 patients concerned for mortality. The results indicated that PPC can reduce the early mortality ((22.6%) vs (39.2%), relative risk, RR (0.50), 95% confidence interval, CI(0.32)～(1.06),P=(0.007)). Four studies involving 146 patients concerned for efficacy. The combined results showed that PPC had positive effect on alcoholic/fatty liver((83.5%) vs (41.7%), RR(2.20); 95% CI(1.08)～(4.50)). Three articles including 546 patients reported the result of biopsy. The combined results showed that the drug had no effect on histology improving. But the drug has the trend for preventing histology warnsening.Conclusion PPC treatment is effective for alcoholic/fatty liver and improve the clinic symptoms and singns. It has the positive tendency of reducing mortality and prevent histology worsening for alcoholic /fatty liver.