Long-term pioglitazone use in MASLD patients: insights from a multicentric preliminary study

Area of Science:

• Hepatology
• Metabolic Disorders
• Pharmacology

Background:

• Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a growing health concern.
• Non-invasive biomarkers are crucial for assessing liver health in MASLD.
• Long-term treatment effects of pioglitazone on MASLD require further investigation.

Purpose of the Study:

• To evaluate the long-term impact of pioglitazone on liver stiffness, steatosis, and other non-invasive biomarkers in MASLD patients.
• To assess the efficacy of pioglitazone over different treatment durations (1-3 years vs. 4-10 years).

Main Methods:

• Multi-center retrospective study of 65 MASLD patients treated with pioglitazone (30-45 mg/day).
• Evaluation of Vibration-Controlled Transient Elastography (VCTE), Controlled Attenuation Parameter (CAP), and FibroScan-AST score before and after treatment.
• Stratification into two groups based on treatment duration: 1-3 years and 4-10 years.

Main Results:

• Significant reductions in Alanine Aminotransferase (ALT) and Gamma-Glutamyl Transferase (GGT) were observed in both groups.
• A significant decrease in CAP, indicating reduced liver steatosis, was noted in the 4-10 year group.
• Improvement in FAST™ scores was significant in both treatment duration groups.

Conclusions:

• Long-term pioglitazone therapy demonstrates significant metabolic and hepatic benefits in MASLD patients.
• Pioglitazone shows potential as a cost-effective and accessible treatment for MASLD.
• Findings support pioglitazone's role in MASLD management, particularly in resource-limited settings.