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Saroglitazar Versus Simvastatin for Metabolic and Alcohol-Associated Liver Disease (MetALD)

Cureus. 2025 Jun 9;17(6):e85652. doi: 10.7759/cureus.85652. eCollection 2025 Jun.

ABSTRACT

Individuals with steatotic liver disease who consume significant amounts of alcohol and meet at least one cardiometabolic criterion are classified as having metabolic and alcohol-associated liver disease (MetALD). The efficacy of saroglitazar and simvastatin in this population remains unclear. In this single-center retrospective cohort study, 102 patients with MetALD were included. The reduction in CAP score was greater in the saroglitazar group (-40 (-109 to 3) dB/m) compared to the simvastatin group (-33 (-100 to 36) dB/m), although this difference did not reach statistical significance (P = 0.08). However, a significant difference was observed in the change in liver stiffness measurement (LSM) scores, with the saroglitazar group showing a greater reduction (-1.9 (-19.5 to 26.3) kPa) than the simvastatin group (-0.8 (-12.2 to 9) kPa) (P = 0.01). Saroglitazar also demonstrated a more pronounced effect on glycosylated hemoglobin (HbA1c), with a median decrease of -0.61 ± 0.96 compared to -0.1 ± 0.4 in the simvastatin group (P = 0.02). Saroglitazar is more effective than simvastatin in reducing CAP, LSM, and HbA1c over six months. Further prospective, well-controlled randomized studies are warranted to validate these findings.

PMID:40642726 | PMC:PMC12240681 | DOI:10.7759/cureus.85652

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