S-adenosyl-L-methionine treatment for alcoholic liver disease: A double-blinded, randomized, placebo-controlled trial

Valentina Medici, Maria C. Virata, Janet M. Peerson, Sally P. Stabler, Samuel W. French, Jesse F. Gregory, Anthony Albanese, Christopher Bowlus, Sridevi Devaraj, Edward A Panacek, John R Richards, Charles H. Halsted

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Background: S-adenosyl-L-methionine (SAM) is the methyl donor for all methylation reactions and regulates the synthesis of glutathione, the main cellular antioxidant. Previous experimental studies suggested that SAM may benefit patients with established alcoholic liver diseases (ALDs). The aim of this study was to determine the efficacy of SAM in treatment for ALD in a 24-week trial. The primary endpoints were changes in serum aminotransferase levels and liver histopathology scores, and the secondary endpoints were changes in serum levels of methionine metabolites. Methods: We randomized 37 patients with ALD to receive 1.2g of SAM by mouth or placebo daily. Subjects were required to remain abstinent from alcohol drinking. A baseline liver biopsy was performed in 24 subjects, and a posttreatment liver biopsy was performed in 14 subjects. Results: Fasting serum SAM levels were increased over timed intervals in the SAM treatment group. The entire cohort showed an overall improvement of AST, ALT, and bilirubin levels after 24weeks of treatment, but there were no differences between the treatment groups in any clinical or biochemical parameters nor any intra- or intergroup differences or changes in liver histopathology scores for steatosis, inflammation, fibrosis, and Mallory-Denk hyaline bodies. Conclusions: Whereas abstinence improved liver function, 24weeks of therapy with SAM was no more effective than placebo in the treatment for ALD.

Original languageEnglish (US)
Pages (from-to)1960-1965
Number of pages6
JournalAlcoholism: Clinical and Experimental Research
Issue number11
StatePublished - Nov 2011


  • Alcoholic liver disease
  • S-adenosyl-L-methionine
  • S-adenosylmethionine

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Toxicology


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