Effect of LIV-52 for the Treatment of Hepatic Disorders: A Systematic Review and Meta-Analysis.

Abstract

Background: Chronic liver diseases (CLDs) are major contributors to hepatic disorder-related morbidity and mortality worldwide. LIV-52, a herbo-mineral product, has demonstrated anti-inflammatory and immunomodulatory properties. Objective: Several randomized controlled trials (RCTs) have been conducted to verify its hepatoprotective effects across diverse patient groups with CLDs. This study aims to perform a meta-analysis to evaluate the therapeutic efficacy of LIV-52 in liver diseases. Data Sources: PubMed, the Cochrane Library, EMBASE, and Web of Science were searched to identify eligible RCTs published through March 10, 2025, where the efficacy of LIV-52 was compared with usual treatments for liver diseases. Meta-analysis was performed using RevMan and GRADEPro software. Eligibility Criteria: RCTs comparing LIV-52 with or without standard care in patients with CLDs. Data Collection and Analysis: Data were extracted independently by two reviewers. Meta-analysis was performed using a random-effects model. Results: From the 10 RCTs involving 758 patients, the hepatoprotective effects of LIV-52 treatment were examined. Benefits were noted in the areas of appetite loss (odds ratio = 0.25, confidence interval [CI] = 0.06 to 1.00, p-value = 0.05), renormalization of the liver enzyme serum-glutamic-pyruvic transaminase (SGPT; mean difference [MD] = -16.37, CI = -30.87 to -1.88, p-value <0.03), and improvement in fat metabolism in patients with liver cirrhosis (zinc sulfate [ZnS] turbidity [MD = 6.76, CI = 2.4 to 11.12, p-value <0.002] and fecal fat secretion [MD = -1.66, CI = -2.53 to -0.75, p-value <0.0001]). However, no significant effects of LIV-52 were observed for liver enzymes such as serum-glutamic-oxaloacetic transaminase, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, and the hematological parameters. The overall quality of evidence (QoE) as assessed using GRADEPro ranged from very low to moderate, with the majority of comparisons supported by low or very low due to small sample sizes and high bias risks, while the findings for some outcomes, hemoglobin and prothrombin time outcomes, supported moderate-quality evidence. Adverse events (AEs) were assessed in three RCTs; no intervention-related AEs were reported. Conclusion: The findings of this meta-analysis suggest that LIV-52 offers certain hepatoprotective benefits, particularly in improving appetite, normalizing SGPT levels, and enhancing fat metabolism in patients with liver diseases. The broader efficacy of LIV-52 is limited, and the low QoE warrants cautious interpretation. Further high-quality, large-scale studies are needed to enhance the certainty of evidence and confirm the LIV-52 efficacy and safety across all outcomes.