Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Phospholipids, particularly essential phospholipids derived from sources such as soybeans, have been studied as a supportive treatment for liver diseases including cirrhosis. The rationale is based on their structural role in cell membranes. In liver disease, membrane integrity and function are compromised, and supplementation is thought to help restore hepatocyte (liver cell) membrane structure, improve membrane-dependent enzyme activity, and reduce progression of fibrosis. Several clinical studies, primarily from Eastern Europe and Asia, have investigated formulations like "Essentiale" (containing polyenylphosphatidylcholine), with some reporting improvements in liver enzyme levels (ALT, AST), histological findings, and subjective symptoms in patients with chronic liver diseases, including cirrhosis. However, systematic reviews and meta-analyses—including a 2013 Cochrane review—conclude that the existing evidence is of low quality, with methodological limitations, small sample sizes, and inconsistent endpoints. No convincing data demonstrate improved survival or significant prevention of liver-related complications. Thus, while there is a scientific basis and some clinical investigation supporting phospholipid use in cirrhosis, the evidence is insufficient and not robust enough for strong recommendations. Major liver societies (AASLD, EASL) do not recommend phospholipids as standard therapy. In summary, while phospholipids are used in some countries and supported by plausible mechanisms and limited trials, scientific evidence for their efficacy in cirrhosis is weak (rated 2/5).

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