Impact of pemafibrate in patients with metabolic dysfunction‐associated steatotic liver disease complicated by dyslipidemia: A single‐arm prospective study

• Published in: JGH open Vol. 8; no. 4; pp. e13057 - n/a
• Main Authors: Ono, Hiroki, Atsukawa, Masanori, Tsubota, Akihito, Arai, Taeang, Suzuki, Kenta, Higashi, Tetsuyuki, Kitamura, Michika, Shioda‐Koyano, Kaori, Kawano, Tadamichi, Yoshida, Yuji, Okubo, Tomomi, Hayama, Korenobu, Itokawa, Norio, Kondo, Chisa, Nagao, Mototsugu, Iwabu, Masato, Iwakiri, Katsuhiko
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.04.2024; John Wiley & Sons, Inc; Wiley
• Subjects: Alcohol use; Biochemistry; Biopsy; Cholesterol; Diabetes; Females; Glucose; High density lipoprotein; homeostasis model assessment‐insulin resistance; Insulin resistance; Laboratories; Lipids; Liver cirrhosis; Liver diseases; liver fibrosis; Low density lipoprotein; Metabolic disorders; metabolic dysfunction‐associated steatotic liver disease; non‐alcoholic fatty liver disease; Original; Patients; pemafibrate; Performance evaluation; Ultrasonic imaging; Variables; Vitamin E; Japan; pemafibrate; liver fibrosis; homeostasis model assessment‐insulin resistance; non‐alcoholic fatty liver disease; metabolic dysfunction‐associated steatotic liver disease
• ISSN: 2397-9070; 2397-9070
• DOI: 10.1002/jgh3.13057

Background and Aim This study aimed to clarify the efficacy and safety of 48‐week pemafibrate treatment in patients with metabolic dysfunction‐associated steatotic liver disease (MASLD) complicated by dyslipidemia. Methods A total of 110 patients diagnosed with MASLD complicated by dyslipidemia received pemafibrate at a dose of 0.1 mg twice daily for 48 weeks. Results The participants were 54 males and 37 females, with a median age of 63 (52–71) years. Besides improvement in lipid profile, significant reductions from baseline to 48 weeks of treatment were found in liver‐related enzymes, such as aspartate aminotransferase, alanine aminotransferase (ALT), gamma‐glutamyl transpeptidase, and alkaline phosphatase (P < 0.001 for all). A significant decrease in the homeostasis model assessment‐insulin resistance (HOMA‐IR) was observed in patients with insulin resistance (HOMA‐IR ≥ 2.5) (4.34 at baseline to 3.89 at Week 48, P < 0.05). Moreover, changes in ALT were weakly correlated with those in HOMA‐IR (r = 0.34; p < 0.05). Regarding noninvasive liver fibrosis tests, platelets, Wisteria floribunda agglutinin‐positive Mac‐2‐binding protein, type IV collagen 7s, and the non‐alcoholic fatty liver disease fibrosis score significantly decreased from baseline to Week 48. Most adverse events were Grades 1–2, and no drug‐related Grade 3 or higher adverse events were observed. Conclusion This study demonstrated that 48‐week pemafibrate administration improved liver‐related enzymes and surrogate marker of liver fibrosis in patients with MASLD. The improvement of insulin resistance by pemafibrate may contribute to the favorable effect on MASLD complicated by dyslipidemia. This study demonstrated that 48‐week pemafibrate administration improved liver‐related enzymes and surrogate marker of liver fibrosis in patients with MASLD.