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Updated: Sep 10, 2025

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

Isabel Veloso Alves Pereira1, Ana Beatriz Souza de Oliveira1, Patricia Momoyo Yoshimura Zitelli1

  • 1Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas HCFMUSP (LIM-07), Departamento de Gastroenterologia e Nutrologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Clinics (Sao Paulo, Brazil)
|August 22, 2025
PubMed
Summary
This summary is machine-generated.

Long-term pioglitazone therapy significantly improved liver enzymes and steatosis in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) patients. This suggests pioglitazone is a valuable treatment option, especially where alternatives are limited.

Keywords:
MASHMASLDPioglitazone

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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.