In pediatric nonalcoholic fatty liver disease (NAFLD) cases, no significant decrease in alanine aminotransferase (ALT) was achieved with losartan (an angiotensin II receptor blocker) than placebo in this study.

• In a multicenter, double-masked, placebo-controlled, randomized clinical trial, 83 eligible children with histologically-confirmed NAFLD (81% male, 80% Hispanic) were randomized to losartan (n=43) or placebo (n=40).

• No significant difference in “24-week ALT change” was found between losartan vs placebo groups (adjusted mean difference: 1.1 U/L), although a significant reduction in alkaline phosphatase was noted in the losartan group (adjusted mean difference: -23.4 U/L).

• Decline in systolic blood pressure in the losartan group but elevation in placebo group was evident (adjusted mean difference: -7.5 mmHg).

• Between groups, compliance by pill counts and numbers and types of adverse events did not vary.