Combination Therapy Using Pemafibrate and Dapagliflozin for Metabolic Dysfunction-associated Fatty Liver Disease

Area of Science:

• Hepatology
• Metabolic Diseases
• Nephrology

Background:

• Metabolic syndrome components like diabetes, obesity, and dyslipidemia are linked to metabolic dysfunction-associated fatty liver disease (MAFLD).
• Effective therapeutic strategies for MAFLD are still under development.
• Obesity-related focal segmental glomerulosclerosis can lead to nephrotic syndrome.

Observation:

• A 37-year-old male patient presented with obesity (BMI 39.0), MAFLD, and nephrotic syndrome.
• The patient had hypertriglyceridemia, hyperglycemia, hepatic injury, and proteinuria.

Findings:

• Combination therapy with pemafibrate (a selective peroxisome proliferator-activated receptor α modulator) and dapagliflozin (a sodium-glucose cotransporter 2 inhibitor) was administered.
• Body weight reduction was also part of the treatment plan.
• This combined approach successfully ameliorated the patient's hypertriglyceridemia, hyperglycemia, hepatic injury, and proteinuria.

Implications:

• Dual therapy with a PPARα agonist and SGLT2 inhibitor, combined with weight loss, may be a viable strategy for treating MAFLD.
• This approach could offer a dual benefit for patients with MAFLD and associated metabolic and renal complications.
• Further research is warranted to confirm the efficacy and safety of this combination therapy in a broader patient population.