Pemafibrate Dramatically Ameliorated the Values of Liver Function Tests and Fibrosis Marker in Patients with Non-Alcoholic Fatty Liver Disease

Abstract

Background Non-alcoholic fatty liver disease ( NA FLD) is a ch ronic liver disease related to metabolic syndrome, which can progress to liver cirrhosis. Standard medication has not been established. Pemafibrate is a selective peroxisome proliferatoractivated receptor (PPAR) α modulator. We retrospectively evaluated the efficacy of pemafibrate in patients with NAFLD. Methods We retrospectively enrolled 17 patients (ten men, seven women; median age, 63 years; range, 27-81 years). They were all proven to have fatty liver through imaging and had little or no history of drinking (ethanol consumption of < 20 g/day for women and < 30 g/day for men). They were administered pemafibrate from October 2018 to June 2020. Results After administration, serum triglyceride (TG) tended to be decreased (300.5 ± 22.5 to 239.5 ± 34.3 mg/dL, P = 0.06). Serum high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol levels did not change. ALT was significantly decreased (-47.4%) for six months (57.5 ± 8.8 to 30.3 ± 5.8 U/L, P < 0.01). The values of serum GGT significantly decreased (-48.7%) for sixth months (63.9 ± 10.3 to 32.8 ± 6.6 U/L, P < 0.01). Aspartate aminotransferase (AST) to platelet ratio (APRI), a fibrosis marker, also was significantly decreased in the sixth month (0.7 ± 0.1 to 0.4 ± 0.1, P < 0.05). Body mass index (BMI) and hemoglobin A1c (HbA1c) showed no significant change. Conclusion Pemafibrate dramatically ameliorated the values of liver function tests and APRI in patients with NAFLD.

Effect of 48‐week pemafibrate on non‐alcoholic fatty liver disease with hypertriglyceridemia, as evaluated by the FibroScan‐aspartate aminotransferase score

“…Pemafibrate was also reported to significantly reduce alanine aminotransferase (ALT) and γ‐glutamyl transpeptidase (γ‐GTP) 11 . Recent studies have reported the efficacy and safety of pemafibrate for patients with NAFLD 12–14 . We also revealed the efficacy and safety of pemafibrate for biopsy‐proven NASH patients 15 .…”

“… 11 Recent studies have reported the efficacy and safety of pemafibrate for patients with NAFLD. 12 , 13 , 14 We also revealed the efficacy and safety of pemafibrate for biopsy‐proven NASH patients. 15 Although the study population was small and the duration of treatment was short in these previous studies, pemafibrate is expected to be a promising treatment for NAFLD patients with hypertriglyceridemia.…”

Pemafibrate improves hepatic inflammation, function and fibrosis in patients with non-alcoholic fatty liver disease: a one-year observational study

“…There are some advantages to this study. First, the treatment period with pemafibrate on NAFLD in this study is longer than in past studies, which had 12-24 weeks of follow-up [ 6 , 7 ]. Second, no patients with diabetes were included.…”

“…We previously reported the short-term outcomes of patients with NAFLD treated with pemafibrate that showed significant improvement in markers of hepatic inflammation and function at three months [ 5 ]. Existing studies reporting the effects of pemafibrate in patients with NAFLD are limited to short-term outcomes [ 6 , 7 ]. There are no reports of long-term outcomes in the literature at this time.…”

Impact of Pemafibrate in Patients with Hypertriglyceridemia and Metabolic Dysfunction-associated Fatty Liver Disease Pathologically Diagnosed with Non-alcoholic Steatohepatitis: A Retrospective, Single-arm Study

“…A single-arm prospective study reported by Seko et al ( 22 ) showed that the levels of transaminase, γ-GTP and fasting TG at baseline were significantly reduced and that HDL cholesterol and the platelet count were significantly elevated in comparison to the values at 12 weeks in 20 patients with NAFLD. Another retrospective study ( 23 ) showed that the transaminase and γ-GTP levels were decreased in patients with fatty liver disease who were treated with pemafibrate. The results of the previous studies were considered to be consistent with the present results.…”