Scientists may be on the brink of a groundbreaking discovery that could revolutionize the treatment of liver disease. Recent research suggests that two widely used medications might hold the key to reversing this condition.

The disease in question, known as metabolic dysfunction-associated steatotic liver disease (MASLD), is not caused by excessive alcohol consumption, which is typically associated with liver issues.

MASLD arises when there is an accumulation of excess fat within the liver, a problem that appears to be escalating in the UK.

Now, Spanish scientists have discovered that combining pemafibrate — a drug typically used in Japan to tackle high cholesterol — and telmisartan, often used in the UK to slash high blood pressure, could ‘significantly’ reduce fat build up. 

The study, conducted on rats and zebrafish, also revealed that this drug combination could decrease complications related to the heart and blood vessels.

Experts today labelled the findings ‘important’ and said using the drug duo could prove a potentially safer and more effective option than current limited treatment options. 

Professor Marta Alegret, an expert in pharmacy and food sciences at the University of Barcelona and study co-author said the combination was beneficial not only for liver disease, but also because ‘it lowers blood pressure and cholesterol levels, and all this would result in a lower cardiovascular risk.’

She added: ‘Mortality from cardiovascular causes is significant in patients with MASLD, and often these patients also have these two risk factors together.’ 

Spanish scientists have discovered that combining pemafibrate — a drug to tackle high cholesterol — and telmisartan, often used to slash high blood pressure, could ‘significantly’ reduce fat build up

In the study, the scientists evaluated the potential of pemafibrate and telmisartan on MASLD when taken both together and separately. 

They found when taken in combination, the two drugs reversed fat accumulation in the liver triggered by a diet high in fat and fructose — a sugar found naturally in fruits, vegetables, and honey and added to products including fizzy drinks, sweets and processed foods.

During tests on rats, they also discovered a combination of half a dose of pemafibrate and half a dose of telmisartan was as effective as a full dose of either drug in reducing fat accumulation. 

Writing in the journal Pharmacological Research, the researchers said: ‘Telmisartan is a drug that has been used in other models of MASLD, but mostly in more advanced stages of the disease.

‘Its beneficial effects have been attributed mainly to anti-inflammatory and anti-fibrotic effects. 

‘But in the early stages of the disease there is no inflammation or fibrosis yet, only lipid [fat] accumulation.’ 

Instead, the scientists found that telmisartan actually restored the levels of PCK1 protein in the liver, which was lacking in the animals with MASLD. 

However, the researchers acknowledged that the findings could not prove the two drugs reversed MASLD given the research was carried out on animals.  

Known medically as metabolic dysfunction-associated steatotic liver disease (MASLD), the condition is not linked to heavy drinking—the more commonly known cause of liver problems

‘In order to be translated into a treatment for MASLD patients, clinical studies would be needed to show that the benefits observed in animal models also occur in humans,’ Professor Alegret said. 

Where liver disease was once largely confined to the elderly and heavy drinkers, it is now rising rapidly among younger adults.

Cases in children have doubled over the past two decades.

The British Liver Trust estimates the condition may now affect one in five people in the UK—though experts have warned the true figure could be as high as 40 per cent.

Worryingly, around 80 per cent of those affected remain undiagnosed, as the disease often has no obvious symptoms—or it has symptoms that are mistaken for less serious problems.

In most cases, it is only spotted during routine blood tests or liver function tests carried out for unrelated issues.  

People with MASLD have excess fat in their liver and one or more metabolic risk factors, which can include obesity, high blood sugar and high blood pressure.

Roughly one in four patients has a more advanced form called metabolic dysfunction-associated steatohepatitis, or MASH. 

In this condition, fat buildup has led to inflammation, cell damage and, in some cases, liver scarring. 

Up to 1 in 5 people with MASH will progress to cirrhosis — advanced, irreversible scarring of the liver — which can lead to liver failure and increase the risk of liver cancer.

When liver function starts to decline, though, patients can accumulate fluid in the abdomen, develop jaundice or experience confusion caused by a buildup of toxins in the bloodstream.