Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as fatty liver disease, affects about one in three adults worldwide and poses major health risks, not only for the liver but also for the heart. Now, an international research team led by the University of Barcelona has found that a combination of two existing drug, pemafibrate and telmisartan, according to World Pharma News, may offer a promising new treatment for this widespread condition, potentially tackling both liver fat and cardiovascular complications.
Repurposing Safe, Existing Medications
MASLD is characterized by the buildup of fat in liver cells, which can progress to severe liver damage and is closely linked to a higher risk of death from cardiovascular disease. Despite the prevalence of MASLD, current treatment options remain limited, largely because many experimental drugs have failed due to safety concerns. To overcome this hurdle, researchers focused on drug repurposing: using medications already approved for other conditions and known to have acceptable safety profiles in humans.
Pemafibrate, a lipid-lowering agent (approved in Japan for hyperlipidemia), and telmisartan, a blood pressure medication, were chosen for their established roles in managing cardiovascular risk factors often present in MASLD patients. The research team tested the drugs individually and in combination in both rat and zebrafish models of MASLD.
Synergistic Benefits and Mechanistic Insights
Results showed that both drugs, given alone or together, reduced fat accumulation in the liver. Notably, using half doses of both drugs together was as effective in reversing liver fat as a full dose of either drug, suggesting a potentially safer and more effective combination strategy. This approach addresses disease from different angles—pemafibrate targets lipid metabolism, while telmisartan, according to the study, acts via the PCK1 protein to shift liver metabolism from fat to glucose production, without raising blood sugar to dangerous levels.
Beyond liver health, the drug combination also lowered blood pressure and cholesterol, offering the prospect of reducing the overall cardiovascular risks tightly linked to MASLD. This dual benefit is crucial, since cardiovascular mortality remains a leading cause of death in people with this liver disorder.
Looking Ahead: From Lab to Clinic
While the findings are compelling, the research is still in the preclinical stage. Animal models, though informative, do not always predict human outcomes. Clinical trials will be essential to confirm whether the benefits seen in rats and zebrafish translate to patients with early-stage MASLD.
The research team is already planning further studies to assess the combination’s effectiveness in more advanced disease stages, including liver fibrosis, and will explore its impact on both liver and cardiovascular disease in tandem.
