Existing Heart and Blood Pressure Medications Could Reverse Silent Fatty Liver Disease Epidemic

Researchers find that combining pemafibrate and telmisartan reverses liver fat and protects heart health in a new study reported by ScienceDaily.

By: AXL Media

Published: Apr 22, 2026, 7:38 AM EDT

Source: Information for this report was sourced from ScienceDaily

Repurposing Established Pharmaceuticals for Liver Health

A research team led by Professor Marta Alegret has identified a potential new application for two existing medications to treat metabolic dysfunction-associated steatotic liver disease (MASLD). By pairing pemafibrate, a lipid-lowering agent, with telmisartan, a widely used blood pressure medication, scientists successfully reversed hepatic fat accumulation in experimental models. This strategy of drug repurposing is particularly significant for MASLD, as many experimental therapies have failed clinical trials due to safety concerns. Utilizing drugs with established safety profiles could accelerate the delivery of treatments for a condition that currently affects approximately one in three adults globally.

Synergistic Benefits of Low-Dose Combination Therapy

The study demonstrated that using half-doses of both drugs in combination was as effective as a full dose of either medication administered alone. This finding suggests a synergistic effect that could minimize the risk of toxicity and side effects in human patients. In the animal models, which included both rats and zebrafish larvae, the dual treatment not only cleared liver lipids but also improved systemic markers of health. According to the research, this combined approach lowers cholesterol levels and blood pressure, addressing the high cardiovascular mortality rates often associated with chronic liver dysfunction.

Restoring Metabolic Flux Through PCK1 Regulation

The investigation revealed a previously unknown biological mechanism behind telmisartan’s efficacy in the liver. Researchers found that MASLD typically causes a significant drop in levels of the PCK1 protein, which disrupts how the liver processes nutrients. Treatment with telmisartan restored PCK1 levels, effectively diverting the flow of metabolites away from lipid synthesis and toward glucose production. Crucially, the study noted that this increase in glucose did not lead to elevated blood sugar levels or diabetes markers, indicating that the liver was managing the metabolic shift safely without systemic complications.