2 Common Drugs May Show Dual Benefit in Fatty Liver and Heart Disease: Study

MASLD is now the most prevalent liver disorder globally, affecting around one in three adults. It occurs when excess fat accumulates in liver cells, increasing the risk of liver damage and cardiovascular mortality. The researchers explored whether combining pemafibrate, a lipid-lowering drug approved in Japan, and telmisartan, an antihypertensive commonly prescribed worldwide, could offer dual protection.

Using a rat model and zebrafish larvae, the team evaluated the drugs' ability to reduce liver fat accumulation. The study showed that the combined treatment reversed liver fat buildup caused by a high-fat, high-fructose diet. Notably, using half doses of both drugs proved as effective as full doses of either, pointing to potential synergy and reduced toxicity.

Each drug appeared to work through distinct biological pathways. Telmisartan, in particular, was found to restore normal levels of the PCK1 protein, which diverts metabolites away from lipid synthesis and toward glucose production. "This increase in PCK1 diverts the flux of metabolites from lipid synthesis to glucose synthesis. This increase in glucose production could be negative if the glucose were exported and accumulated in the blood, as it could lead to diabetes, but we have noticed that this is not the case," Marta Alegret, a professor at the University of Barcelona's Faculty of Pharmacy and Food Sciences.

Although clinical application is still distant, this research offers a compelling case for further human studies.

References: Roger Bentanachs, Patricia Ramírez-Carrasco, Bianca Braster, Anastasia Emmanouilidou, Endrina Mujica, Maite Rodrigo-Calvo, Cristina Rodríguez, Núria Roglans, Marcel den Hoed, Juan C. Laguna, Marta Alegret. Telmisartan reverses hepatic steatosis via PCK1 upregulation: A novel PPAR-independent mechanism in experimental models of MASLD. Pharmacological Research, 2025; 218: 107860 DOI: 10.1016/j.phrs.2025.107860