Published online Dec 27, 2020. doi: 10.4254/wjh.v12.i12.1258
Peer-review started: June 9, 2020
First decision: September 18, 2020
Revised: October 7, 2020
Accepted: November 12, 2020
Article in press: November 12, 2020
Published online: December 27, 2020
Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the world and can be life-threatening, with some cases progressing to end-stage liver disease. Yet, there is no effective treatment available for it.
Proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors have produced favorable effects on liver function in some studies. This prompted our interest in determining whether PCSK9 inhibitors can elicit a therapeutic effect on hepatic steatosis.
Radiologic resolution of hepatic steatosis was the primary outcome, and improvement in liver function biomarkers was the secondary outcome.
This study was designed as a retrospective chart review and included the medical records of 29 adult patients (18 years and above in age) who had received PCSK9 inhibitors anytime from January 2015 to July 2019.
Among the total 29 patients, 11 were found to have radiologic diagnosis of hepatic steatosis. Eight of these eleven patients (72.73%) achieved complete radiologic resolution of hepatic steatosis after using PCSK9 inhibitors for a mean duration of 17.6 mo. Levels of both alanine aminotransferase and aspartate aminotransferase levels also showed a downward trend after use of PCSK9 inhibitors for about 2 years.
PCSK9 inhibitors can slow down or even result in complete resolution of NAFLD.
The findings from this study, in conjunction with those from similar studies, can serve as the basis for future prospective research to further explore the effects of PCSK9 inhibitors on hepatic steatosis. PCSK9 inhibitors may represent a significant breakthrough treatment for NAFLD, if prospective studies corroborate the current findings.