Abstract

Saroglitazar, a dual peroxisome proliferator activated receptor α/γ agonist, approved for diabetic dyslipidemia (DD), is potential therapeutic option for non-alcoholic fatty liver disease (NAFLD). This prospective, observational, real-world study aimed to determine efficacy and safety of Saroglitazar in patients with NAFLD and DD. We included patients with DD and NAFLD who received Saroglitazar 4 mg once daily for 24 weeks. Blood investigations, liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) (FibroScan) were compared at baseline and 24 weeks. Of 163 patients screened, 107 were included, and 101 completed 24 weeks treatment (mean age 50.4 ± 12.3 years, 78.5% males, mean body mass index 28.8 ± 4.2). After 24 weeks, alanine transaminase (ALT) reduced significantly from 94 (47–122) to 39 (31–49) (p < 0.0001) and aspartate aminotransferase (AST) (U/L) from 89 (43–114) to 37 (30–47) (p < 0.0001) and LSM (kPa) from 8.4 (7.1–9.3) to 7.5 (6.4–8.4) (p = 0.0261). CAP, glycated hemoglobin and lipid parameters also improved significantly. On linear regression, there was significant association between percent change in ALT and AST with TG reduction after treatment (p = 0.024 and 0.037 respectively).We conclude that Saroglitazar leads to significant improvement in transaminases, LSM, and CAP in NAFLD patients with DD.

Highlights

  • Saroglitazar, a dual peroxisome proliferator activated receptor α/γ agonist, approved for diabetic dyslipidemia (DD), is potential therapeutic option for non-alcoholic fatty liver disease (NAFLD)

  • The spectrum of NAFLD ranges from nonalcoholic fatty liver to nonalcoholic steatohepatitis (NASH), which can further progress to cirrhosis and hepatocellular carcinoma

  • The specific alteration in lipid profile in Type 2 Diabetes Mellitus (T2DM) patients characterised by increased triglyceride (TG), increased proportion of small dense low-density lipoprotein cholesterol (LDL-C) and decreased high-density lipoprotein cholesterol (HDL-C) is known as diabetic dyslipidemia (DD)[2]

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Summary

Introduction

Saroglitazar, a dual peroxisome proliferator activated receptor α/γ agonist, approved for diabetic dyslipidemia (DD), is potential therapeutic option for non-alcoholic fatty liver disease (NAFLD). This prospective, observational, real-world study aimed to determine efficacy and safety of Saroglitazar in patients with NAFLD and DD. The specific alteration in lipid profile in T2DM patients characterised by increased triglyceride (TG), increased proportion of small dense low-density lipoprotein cholesterol (LDL-C) and decreased high-density lipoprotein cholesterol (HDL-C) is known as diabetic dyslipidemia (DD)[2]. Saroglitazar received approval from Drugs Controller General of India for treatment of patients with DD in 2­ 0135

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