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The liver plays a crucial role in many bodily functions. It detoxifies harmful substances, metabolises nutrients, stores vitamins and minerals, and regulates cholesterol levels. Despite its importance, the liver is susceptible to several serious conditions that can lead to irreversible damage if left untreated. Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) refers to a range of liver diseases associated with metabolic dysfunction, primarily characterised by the accumulation of fat in liver cells. Previously referred to as Non-Alcoholic Fatty Liver Disease (NAFLD), MASLD is closely linked to various metabolic issues, such as obesity, insulin resistance, and type 2 diabetes.

According to a new Lancet global study, published in The Lancet Gastroenterology & Hepatology, nearly 2 billion people worldwide could be living with metabolic liver disease by 2050. Currently, about 1.3 billion people are affected by this condition, and that number is projected to increase significantly in the coming decades.

While the prevalence of fatty liver is on the rise, emerging studies indicate that there are treatment options for this serious condition. A study published in Pharmacological Research suggests that combining two existing drugs can effectively reduce liver fat more efficiently than using either drug alone. This combination allows for quicker and more effective treatment.

Major findings of the study reveal:

• Two specific medications: Pemafibrate, a drug used to lower fats/lipids and Telmisartan, a common blood pressure medication, can help reverse fat buildup when used together.
• Reversing fat buildup: In animal models, the combination of these two drugs successfully reversed the buildup of fat in the liver caused by unhealthy diets.
• The half-dose benefit: The study found that using a half-dose of each drug together was just as effective as using a full dose of either drug by itself. This is important because lower doses usually mean fewer side effects for patients.
• Double protection (liver and heart): The treatment didn't just help the liver. Because these drugs also target cholesterol and blood pressure, the combination showed potential to reduce cardiovascular risk, which is the leading cause of death for people with fatty liver disease.
• New biological discovery: The scientists discovered a new way these drugs work. They found that Telmisartan helps the liver process fat by activating a specific gene (PCK1) in a way they hadn't seen before.

Understanding Pemafibrate and Telmisartan

Pemafibrate and Telmisartan are medications primarily used to manage cholesterol and blood pressure, respectively. The study suggests that they may also be highly effective when used together to treat fatty liver disease.

Pemafibrate

Pemafibrate is a newer type of drug designed to regulate fats (lipids) in the blood with fewer side effects than older medications in its class.

It treats high triglycerides (fats in the blood) and low good cholesterol (HDL). It activates a protein called PPAR-gamma in the liver, which increases the burning of excess fat and reduces the production of harmful fats.

Telmisartan

Telmisartan is a standard medication for cardiovascular health. It helps maintain healthy blood pressure numbers and reduces the risk of heart attacks or strokes. It is often prescribed for heart failure and kidney problems related to diabetes.

The study also highlights that Pemafibrate and Telmisartan are already approved for use in some parts of the world, and it could be much faster to get this combo treatment to patients who need it.

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