AUTHOR=Sugimoto Ryosuke , Iwasa Motoh , Eguchi Akiko , Tamai Yasuyuki , Shigefuku Ryuta , Fujiwara Naoto , Tanaka Hideaki , Kobayashi Yoshinao , Ikoma Jiro , Kaito Masahiko , Nakagawa Hayato 

TITLE=Effect of pemafibrate on liver enzymes and shear wave velocity in non-alcoholic fatty liver disease patients

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1073025

DOI=10.3389/fmed.2023.1073025

ISSN=2296-858X

ABSTRACT=<sec><title>Background/Aims</title><p>Pemafibrate is a selective peroxisome proliferator-activated receptor α modulator that improves serum alanine aminotransferase (ALT) in dyslipidemia patients. Pemafibrate was reported to reduce ALT in non-alcoholic fatty liver disease (NAFLD) patients, but efficacy was not clearly elucidated due to the small size of previous study populations. Therefore, we explored pemafibrate efficacy in NAFLD patients.</p></sec><sec><title>Methods</title><p>We retrospectively evaluated pemafibrate efficacy on liver enzymes (<italic>n</italic> = 132) and liver shear wave velocity (SWV, <italic>n</italic> = 51) in NAFLD patients who had taken pemafibrate for at least 24 weeks.</p></sec><sec><title>Results</title><p>Patient ALT levels were decreased from 81.0 IU/L at baseline to 48.0 IU/L at week 24 (<italic>P</italic> &lt; 0.0001). Serum levels of aspartate aminotransferase (AST), γ-glutamyl transpeptidase (γ-GTP) and triglyceride (TG) were significantly decreased, and high-density lipoprotein cholesterol and platelet count were significantly increased, with no change in body weight being observed. Study participant SWV values decreased from 1.45 m/s at baseline to 1.32 m/s at week 48 (<italic>P</italic> &lt; 0.001). Older age (<italic>P</italic> = 0.035) and serum TG levels (<italic>P</italic> = 0.048) were significantly associated with normalized ALT. Changes in AST, ALT, γ-GTP and body weight were significantly correlated with change in SWV.</p></sec><sec><title>Conclusion</title><p>Pemafibrate significantly improves liver function, serum TG and liver stiffness in NAFLD patients. Pemafibrate is a promising therapeutic agent for NAFLD and may be a candidate for NAFLD patients with elevated TG.</p></sec>