Objective
Pemafibrate is a recently developed selective
peroxisome proliferator-activated receptor alpha modulator that can improve
alanine aminotransferase (ALT) levels in patients with
nonalcoholic fatty liver disease (
NAFLD). However, the effectiveness of ALT normalization with
pemafibrate and
bezafibrate, a traditional
fibrate, has not been compared. Methods In this retrospective study, we compared the effects of
pemafibrate and
bezafibrate on ALT normalization in patients with
NAFLD. The primary endpoint was the ALT normalization rate at 12 months after administration. Patients Twenty and 14 patients with
NAFLD receiving
pemafibrate and
bezafibrate, respectively, were included in this retrospective analysis. All patients had elevated ALT levels and
dyslipidemia at entry. Results The ALT normalization rates at 3, 6, and 12 months were 40%, 55%, and 60% for
pemafibrate and 14.3%, 28.6%, and 14.3% for
bezafibrate, respectively. The ALT normalization rate at 12 months was significantly higher in patients treated with
pemafibrate than in those treated with
bezafibrate (p=0.01).
Pemafibrate, when compared with
bezafibrate, was shown to be a significant factor for ALT normalization in a multivariable analysis with an adjusted odds ratio (95% confidence interval) of 13.8 (1.6-115, p=0.01). Conclusion
Pemafibrate is effective in ALT normalization in patients with
NAFLD and may be used as a treatment for
NAFLD.