Fibrosis is regressing: Dapagliflozin against fatty liver

The randomized, placebo-controlled study involved 154 people at six Chinese medical centers. 85 percent were men, and the average age was just 35. They had been diagnosed with MASH after a liver biopsy. The abbreviation stands for metabolic dysfunction-associated steatohepatitis, formerly known as non-alcoholic fatty liver disease (NASH). Almost all had already developed liver fibrosis. Forty-five percent had been diagnosed with type 2 diabetes.

Participants received 10 mg of dapagliflozin or placebo once daily for 48 weeks. They also participated in a health education program twice within a year. After 48 weeks, a biopsy was taken again, and liver health was assessed.

The primary endpoint, improvement in MASH without worsening fibrosis, was achieved by 53 percent of the dapagliflozin group compared to 30 percent on placebo. Inflammation even disappeared in 23 percent, compared to 8 percent on placebo. Improvement in fibrosis without worsening MASH was also evaluated. This was the case for 45 percent versus 20 percent in the two groups. The dropout rate was low, with one person on dapagliflozin (1 percent) and two people on placebo (3 percent). "Our results suggest that dapagliflozin may influence important aspects of MASH by improving both steatohepatitis and fibrosis," the study team writes in the British Medical Journal .

To date, there is only one approved drug in the US for fatty liver disease . However, research is underway into numerous new and existing substances , such as semaglutide . This antidiabetic drug has already embarked on a second career as a treatment for heart failure. Fatty liver disease would be a major, third indication. However, this requires further and larger studies, including those with other ethnic groups and a higher proportion of women.