Page 70 - ITPS-7-4

INNOSC Theranostics and
Pharmacological Sciences Role of saroglitazar in MASH

were dramatically lowered after 24 weeks of therapy, patients. It should be highlighted that the sample used, the
suggesting that saroglitazar is useful in reducing liver prospective nature of this study, and the use of non-invasive
inflammation, substantiating its efficacy based on a non- methods for assessing hepatocellular inflammation
alcoholic steatohepatitis population. These findings are and fibrosis are the strengths of this study, despite some
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consistent with previous research, such as that conducted limitations. The small sample size and the brief follow-up
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by Kaul et al. which reported a noteworthy decrease in period were the main limitations of this study. It is a larger
ALT following 12 – 58 weeks of saroglitazar treatment, sample study covering an extended period of follow-up
and another which demonstrated a reduction of 60% in that would be conducted in the future to provide more
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ALT and 43% in AST in animal models with MASLD after in-depth insights. The inability of this study to forecast
12 weeks of saroglitazar treatment. Similarly, Goyal et al. advantage over other compounds now under investigation
observed significant reductions in ALT and AST after using for MASH is also a limitation. In addition, there was a
saroglitazar for 24 weeks, concluding that saroglitazar can lack of follow-up information about whether stopping the
improve hepatic inflammation and resolve transaminitis. 20 medication would result in a reversal of the biochemical
and stiffness parameter improvements or a continued
The ultimate goal of pharmacological treatment is to benefit. However, the study did not address this crucial
reverse liver fibrosis. However, a liver biopsy is usually question owing to the research design employed. The
required for histopathological examination to accurately assessment of cardiovascular outcome was not conducted
detect fibrosis, and this procedure is invasive and as well. There is a strong association between MASH and
impractical. Liver stiffness measurement, which leverages cardiovascular incidents, and the majority of causes of death
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FibroScan as a substitute non-invasive approach for and morbidity in the MASH population are cardiovascular
evaluating liver fibrosis and cirrhosis, has demonstrated in nature; however, the present study did not evaluate any
potential in a number of recent investigations. 22,23 cardiovascular parameters, neither in the pre- nor post-
According to LSM measurements utilizing FibroScan, treatment context. Hence, it is highly anticipated that a
the current study found a substantial decrease in fibrosis. long-term follow-up study will be conducted in the future
Although in our study we did not compare the fibrosis to determine whether there is an increase or decrease in
score directly between pre- and post-treatment groups, cardiovascular outcomes, a research topic this study was
a significant decrease in LSM (kPa) value indirectly not intended to cover. Although underweight patients were
indicates improvements in liver fibrosis and cirrhosis. excluded from this study, the relationship of sarcopenia
Goyal et al. also noted a substantial decrease in LSM after with outcomes in this study was not explored, making it
24 weeks of saroglitazar treatment, and another study one of the limitations of this study.
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reported a reduction in liver fibrosis, measured by shear
wave elastography, following 9 months of saroglitazar It is important to note that although the adverse effects
treatment. 24 of saroglitazar such as hypoglycemia, nausea, and chest
pain have been mentioned in the literature, none of these
In addition to fibrosis assessment, evaluating changes side effects were reported by the patients taking part in this
in liver fat content is an essential parameter for gauging study. Similar research using animal models did not find
the response to MASLD therapy. Although abdominal any adverse consequences. Moreover, no major negative
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ultrasonography can be used as a screening method to effects were reported in human studies. The results of
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diagnose fatty liver, it is not very effective in identifying this study support the idea that individuals receiving
changes in the modest amount of liver fat. With high medication for MASLD may tolerate saroglitazar well.
accuracy in detecting changes in liver fat content, the
CAP, as evaluated by FibroScan, provides an acceptable 5. Conclusion
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option for diagnosing fatty liver. The analysis of the Saroglitazar has a beneficial impact on the medical
current study showed a considerable decrease in liver fat, management of MASH by reducing liver inflammation
as determined by CAP utilizing FibroScan. According through normalization of liver enzymes and reduction of
to Goyal et al. and Kaul et al., there was a noteworthy liver stiffness. It also curtails fat buildup in hepatocytes,
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improvement in liver fat, as evaluated by CAP, following which is manifested in terms of the significant decrease
12 – 58 weeks of saroglitazar therapy in MASLD, which in CAP value. Saroglitazar also lowers the elevated levels
is consistent with our findings. It has also been reported of liver enzymes (SGOT/SGPT) as well as serum LDL
that CAP values significantly decreased after 24 weeks of levels within a duration of 6 months. The findings of this
saroglitazar treatment. 20 study ascertain saroglitazar as a viable treatment option
Very few studies have been conducted to validate the for MASH management. Nonetheless, further research
role of saroglitazar in MASH management in non-diabetic involving a larger sample and longer follow-up period,

Volume 7 Issue 4 (2024) 6 doi: 10.36922/itps.3560