Therapeutic outcome of saroglitazar, a peroxisome proliferator activated receptor α/γ agonist in diabetic and non-diabetic metabolic dysfunction associated steatotic liver disease

Authors

  • Nisar A. Shah Department of Medicine and Gastroenterology, GMC, Srinagar, Jammu and Kashmir, India
  • Shashi Paul Department of Medicine, GMC, Kathua, Jammu and Kashmir, India
  • Shagufta Parveen Department of Pharmacology, GMC, Srinagar, Jammu and Kashmir, India
  • Mohammad Hayat Bhat Department of Endocrinology, GMC, Srinagar, Jammu and Kashmir, India
  • Irfan Ali Department of General Medicine, GMC, Srinagar, Jammu and Kashmir, India
  • Showkat A. Kadla Department of Medicine and Gastroenterology, GMC, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20251836

Keywords:

Metabolic dysfunction, Associated steatotic liver disease, NFS score, Metabolic syndrome, Liver fibrosis

Abstract

Background: Metabolic dysfunction associated steatotic liver disease (MASLD) is the most common cause of chronic liver disease (CLD)and its consequences throughout the world, more so in developed countries. It is more concerning in view of the lack of a definitive treatment. Aside from lifestyle changes and vitamin E, we are still looking for a drug that can improve outcome in this group of patients.

Methods: Authors evaluated the safety and effectiveness of saroglitazar in MASLD/MASH patients in this 48-week prospective observational study, with the primary goal of evaluating the therapeutic outcome of saroglitazar on the NAFLD fibrosis score (NFS) in both diabetics and non-diabetics. After receiving written informed consent from each patient, a total of 292 patients who met the inclusion criteria were enrolled. However, only 257 individuals completed the study. Eligible patients were put on saroglitazar 4 mg per day for 24 weeks and followed on an OPD basis for 48 weeks with special emphasis on NFS, BMI, HbA1c, lipid levels, and liver biochemistry. Authors observed a male dominance (61.9%), a significant improvement in lipid profile, liver biochemistry, HbA1c, NFS, and liver stiffness measurement (LSM), and also an improvement in BMI though not statistically significant. Authors did not observe any significant drug related adverse events during the treatment with saroglitazar.

Conclusion: In our study, saroglitazar at a dose of 4 mg per day for 24 weeks resulted in marked improvements in liver biochemistry, lipid profile, HbA1c, NFS, and LSM, in patients of MASLD/MASH in both diabetics and non-diabetics.

Metrics

Metrics Loading ...

References

E, Cusi K, et al. The diagnosis and management of non-alcoholic fatty liverdisease: practice Guideline by the American Association for the Study of Liver Diseases American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55:237.

Younossi ZM, Stepanova M, Rafiq N, Makhlouf H, Younoszai Z, Agrawal R, Goodman Z. Pathologic criteria for nonalcoholic Steatohepatitis:interprotocol agreement and ability to predict liver-related mortality. Hepatology. 2011;53:1874-82.

Charlton MR, Burns JM, Pedersen RA, Watt KD, Heimbach JK, Dierkhising RA. Frequency and outcomes of liver transplantation for nonalcoholic Steatohepatitis in the United States. Gastroenterology. 2011;141:1249-53.

Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic Steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34:274-85.

Li Z, Xue J, Chen P, Chen L, Yan S, Liu L. Prevalence of nonalcoholic fatty liver disease in mainland of China: a meta-analysis of published studies. J Gastroenterol Hepatol. 2014;29:42-51.

Chan WK, Tan AT, Vethakkan SR, Tah PC, Vijayananthan A, Goh KL. Non-alcoholic fatty liver disease in diabetics— prevalence and predictive factors in a multiracial hospital clinic population in Malaysia. J Gastroenterol Hepatol. 2013;28:1375-83.

Liangpunsakul S, Chalasani N. Unexplained elevations in alanine aminotransferase in individuals with the metabolic syndrome: results from the Third National Health and Nutrition Survey (NHANES III). Am J Med Sci. 2005;329:111-6.

Portillo Sanchez P, Bril F, Maximos M, Lomonaco R, Biernacki D, Orsak B, et al. High prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus and normal plasma aminotransferase levels. J Clin Endocrinol Metab. 2014;2:739.

Kasturiratne A, Weerasinghe S, Dassanayake AS, Rajindrajith S, de Silva AP, Kato N, et al. Influence of non-alcoholic fatty liver disease on the development of diabetes mellitus. J Gastroenterol Hepatol. 2013;28:142-7.

Yamazaki H, Tsuboya T, Tsuji K, Dohke M, Maguchi H. Independent association between improvement of nonalcoholic fatty liver disease and reduced incidence of type 2 diabetes mellitus. Diabetes Care. 2015;38:1673-9.

Rafiq N, Bai C, Fang Y, Srishord M, McCullough A, Gramlich T, et al. Long-term follow-up of patients with nonalcoholic fatty liver. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2009;7:234-8.

EkstedtM, Hagstr€om H, Nasr P, Fredrikson M, Stål P, Kechagias S. Fibrosis stage is the strongest predictor for disease specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2015;61:1547-54.

Stepanova M, Rafiq N, Makhlouf H, Agrawal R, Kaur I, Younoszai Z, et al. Predictors of all-cause mortality and liverrelated mortality in patients with non-alcoholic fatty liver disease (NAFLD). Dig Dis Sci. 2013;58:3017-23.

Farrell GC, Wong VW, Chitturi S. NAFLD in Asia-as common and important as in the West. Nat Rev Gastroenterol Hepatol. 2013;10:307-18.

Clinical Dilemmas in Non–Alcoholic Fatty Liver Disease, First Edition. Edited by Rogre Williams and Simon D. Taylor-Robinson. John Willey and sons Ltd. 2016.

Angulo P, Hui JM, Marchesini G, Bugianesi E. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45:846-54.

Nassir F, Ibdah JA. Role of Mitochondria in Nonalcoholic Fatty Liver Disease. Int J Mol Sci.2014;15:8713-42.

Kusi K. Reviews in Basic and Clinical Gastroenterology and Hepatology. Gastroenterology. 2012;142:711-25.

Pawlak M. Molecular mechanism of PPAR-alpha action and its impact on lipid metabolism, inflammation and fibrosis in non- alcoholic fatty liver disease. J Hepatol. 2015;62:720-33.

Montagner A, Polizzi A, Fouche E. Liver PPARalpha is crucial for whole-body fatty acid homeostasis and is protective against NAFLD. Gut. 2016; 65:1202-14.

Montagner A, Polizzi A, Fouche E. Liver PPARalpha is crucial for whole-body fatty acid homeostasis and is protective against NAFLD. Gut. 2016;65:1202-14.

Sanyal AJ, Ratziu V, Loomba R. Results from a new efficacy and safety analysis of the REGENERATE trial of obeticholic acid for treatment of pre-cirrhotic fibrosis due to non-alcoholic steatohepatitis. J Hepatol. 2023;79(5):1110-20.

Bhosle D, Bhosle V, Bobde J, Bhagat A, Shaikh H, Kadam R. Study of saroglitazarin treatment of pre-diabetes with dyslipidemia: STOP-D. J Assoc Phys India. 2018;66:14-8.

Shetty SR, Kumar S, Mathur RP, Sharma KH, Jaiswal AD. Observational study to evaluate the safety and efficacy of Saroglitazar in Indian diabetic dyslipidemia patients. Indian Heart J. 2015;67(1):23–6

Gawrieh S, Noureddin M, Loo N, Mohseni R, Awasty V, Cusi K, et al. Saroglitazar, a PPAR-α/γ Agonist, for Treatment of NAFLD: A Randomized Controlled Double-Blind Phase 2 Trial. Hepatol. 2021;74(4):1809-24.

Joshi S, Banshi Saboo MB, FICP F, FIACM F, Rajeev Chawla MD, Sudhir Bhandari MD, AFICA F. Saroglitazar in non-alcoholic fatty liver disease. Endo Prac. 2016;22:331.

Chatterjee S, Majumder A, Ray S, Bhattacharjee K. Observational study of Saroglitazar on metabolic parameters in Indian patients with diabetic dyslipidaemia-a fifty-eight weeks of clinical experience. Diabetes Obes Int J. 2018;3(2):180.

Kaul U, Parmar D, Manjunath K, Shah M, Parmar K, Patil KP, et al. New dual peroxisome proliferator activated receptor agonist- Saroglitazar in diabetic dyslipidemia andnon‑alcoholic fatty liver disease: integrated analysis of the real-world evidence. Cardiovasc Diabetol. 2019;18:80.

Goyal O, Nohria S, Goyal P, Kaur J, Sharma S, Sood A, Chhina RS. Saroglitazar in patients with non-alcoholic fatty liver disease and diabetic dyslipidemia: a prospective, observational, real-world study. Sci Rep. 2020;10(1):21117.

Downloads

Published

2025-06-24

How to Cite

Shah, N. A., Paul, S., Parveen, S., Bhat, M. H., Ali, I., & Kadla, S. A. (2025). Therapeutic outcome of saroglitazar, a peroxisome proliferator activated receptor α/γ agonist in diabetic and non-diabetic metabolic dysfunction associated steatotic liver disease. International Journal of Basic & Clinical Pharmacology, 14(4), 519–525. https://doi.org/10.18203/2319-2003.ijbcp20251836

Issue

Section

Original Research Articles