Originally published by our sister publication Gastroenterology & Endoscopy News
By Angely Mercado
A daily dose of aspirin led to a significant reduction in liver fat in patients with metabolic dysfunction–associated steatotic liver disease, according to new research.
Researchers conducted a six-month randomized trial comparing 81 mg of aspirin with a placebo in patients from a Boston hospital (JAMA 2024;331[11]:920-929). The patients in the trial were a mean age of 48 years, were mostly women (55%) and were diagnosed with MASLD without cirrhosis.
Compared with placebo, aspirin treatment reduced the average liver fat content by 10.2%, as assessed by proton magnetic resonance spectroscopy (difference, –10.2%; 95% CI, –27.7% to –2.6%; P=0.009). At the end of the trial, the average change in liver fat was –6.6% with low-dose aspirin versus an increase of 3.6% with placebo. The low-dose aspirin also was found to be safe for the patients, with the most common adverse events being upper respiratory tract infections (10% in both groups) or arthralgias (5% in the aspirin group and 7.5% in the placebo group).
“Until [recently], there were no FDA-approved treatments or methods available,” noted the study’s principal investigator Tracey G. Simon, MD, MPH, a hepatologist at Massachusetts General Hospital, in Boston. Even with the approval of resmetirom (Rezdiffra, Madrigal), “which is also tremendously exciting, there are still no cost-effective and readily accessible options,” Dr. Simon said. “If [the results are] validated, aspirin could represent a very cost-effective and accessible treatment option for this enormous patient population.”
Asked to comment on the findings, Jonathan G. Stine, MD, MSc, the director of the Fatty Liver Program and research director of the Liver Center at Penn State Health, in Hershey, Pa., said he was cautiously optimistic about the study results, especially if they will support the compounding health issues that often are associated with MASLD.
“Up until very recently, we did not have an FDA-approved medication for this condition, and we have historically used medications off-label to treat the leading cause of chronic liver disease worldwide,” he told Gastroenterology & Endoscopy News. “Many of these medications, including the [glucagon-like peptide-1] receptor agonists, such as semaglutide [Ozempic/Wegovy, Novo Nordisk], come with a hefty price tag.”
Dr. Stine pointed out that a combination of lifestyle changes, including a healthy, whole-food diet and exercise, are also an effective way to manage MASLD symptoms. But having extra resources, like a low-cost medicine option, can support better health for those patients.
Dr. Simon underscored that easy access to a low-cost drug would provide another option to support patients who cannot easily make those lifestyle changes.
Dr. Simon reported no relevant financial disclosures. Dr. Stein reported financial relationships with AstraZeneca, Galectin, Kowa, Novo Nordisk and Zydus.
