Fatty Liver cure: Combination of THESE two common cardiovascular drugs could reverse the deadly liver disease

Liver disease is the new “silent killer” that’s quietly becoming one of the world’s biggest health concerns. The most common type among different kinds of liver diseases, fatty liver disease, is surging globally – thanks to obesity, poor diets, and sedentary lifestyles.

Fatty liver disease develops when extra fat accumulates in liver cells, often silently, and can progress into inflammation, fibrosis, cirrhosis, or even liver cancer if left untreated.

While there is no single, definitive cure for fatty liver disease – yet – a promising new study is raising hopes. The research has found that a combination of two well-known cardiovascular drugs may be able to reverse fatty liver disease — a breakthrough in a field that has long lacked effective therapies.

The research suggests that when used together, these medications don’t just slow liver damage — they can actively reduce fat buildup and improve liver health. This is especially promising because both drugs are already approved for other uses, which could speed their adoption for liver treatment after further trials.


The study and the findings

Until now, fatty liver has been known to be reversible only by managing lifestyle changes, especially if caught in its early stages. However, scientists from the University of Barcelona published a paper this month in Pharmacological Research, reporting that combining pemafibrate and telmisartan produces a significant reduction in liver fat in models of MASLD (formerly called NAFLD).

Pemafibrate is a lipid-lowering agent (a fibrate class drug, used to reduce high triglycerides and improve lipid profiles), while telmisartan is a well-known angiotensin II receptor blocker (ARB) used for hypertension. When used together – as per the study – the duo seems to have complementary actions that go beyond what either can do alone. The researchers found that this combination lowered liver lipid accumulation more efficiently and also improved markers of cardiovascular risk.

Because MASLD is closely tied to cardiovascular disease (CVD), the fact that these are cardiovascular drugs makes the finding especially attractive. Many patients with fatty liver also have high blood pressure, dyslipidemia, or other heart risk factors — so a therapy addressing both liver and cardiovascular health could be a major advance.




How do these two drugs work

Pemafibrate: This cardiovascular drug belongs to a class known as selective PPAR-α modulators. It helps to improve lipid metabolism in the liver and blood by increasing fatty acid oxidation (burning fat) and reducing triglyceride synthesis. In animal studies, pemafibrate alone already reduced liver fat accumulation.

Telmisartan: Another cardiovascular drug that is an ARB (angiotensin receptor blocker) commonly used to lower blood pressure. But beyond lowering blood pressure, it has beneficial effects on metabolism — such as improving insulin sensitivity, reducing inflammation, and modifying lipid pathways. In prior work, ARBs and ACE inhibitors have been explored in NAFLD because of their potential effects on liver fibrosis, inflammation, and metabolic stress.


The combination that could reverse fatty liver

The Barcelona team argues the combination works better than either drug alone because they target different, complementary “nodes” in metabolism and disease pathways. Pemafibrate may more directly act on lipid metabolism in liver cells, while telmisartan can modulate inflammatory signaling, insulin resistance, and systemic effects.

The researchers also discovered a new role of a protein called PCK1 (phosphoenolpyruvate carboxykinase 1) in regulating fat metabolism in the liver in their models, pointing to how the drugs might influence deeper biochemical circuits of fat storage and usage.

Because both drugs are already used in human patients (for lipids and hypertension), their safety is well documented, making “drug repurposing” an appealing strategy.



Why this finding matters

MASLD affects up to one in three adults globally and is a leading cause of chronic liver disease. While lifestyle change (diet, exercise, weight loss) remains the first line, drug options are still limited. Additionally, fatty liver disease is not just a liver issue — it increases the risk of cardiovascular disease. Naturally, a drug combo that addresses both liver and cardiovascular risk is doubly attractive. Moreover, because pemafibrate and telmisartan are already approved for other uses, their safety profiles are known. That lowers the barrier and risk of moving into human clinical trials for liver disease.

Furthermore, targeting early disease stages in the case of fatty liver might prevent progression. The study was done in models of early MASLD (before advanced fibrosis). The hope is that intervening early can prevent progression to more serious liver damage (steatohepatitis, fibrosis, cirrhosis).


What’s next

The current evidence comes from rat and zebrafish disease models — not yet in human patients. What works in animals doesn’t always translate to humans. Additionally, the correct doses for liver effect — without causing harm — must be established. When two drugs are given together, their interactions must be carefully studied. What’s more, the combination may be more effective in the early stages. Later stages of liver scarring and fibrosis might require different or additional therapies.

Human clinical trials (phase 1, 2, 3) are needed to test safety, dose, and efficacy. That takes time, funding, and design. Furthermore, identifying which patients will benefit most and monitoring biomarkers (liver enzymes, imaging, biopsies) will be key in trials.

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