{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:45:29Z","timestamp":1793303129363,"version":"4.5.0"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2024,3,19]]},"abstract":"\n Importance<\/jats:title>\n Aspirin may reduce severity of metabolic dysfunction\u2013associated steatotic liver disease (MASLD) and lower the incidence of end-stage liver disease and hepatocellular carcinoma, in patients with MASLD. However, the effect of aspirin on MASLD is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To test whether low-dose aspirin reduces liver fat content, compared with placebo, in adults with MASLD.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This 6-month, phase 2, randomized, double-blind, placebo-controlled clinical trial was conducted at a single hospital in Boston, Massachusetts. Participants were aged 18 to 70 years with established MASLD without cirrhosis. Enrollment occurred between August 20, 2019, and July 19, 2022, with final follow-up on February 23, 2023.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were randomized (1:1) to receive either once-daily aspirin, 81 mg (n\u2009=\u200940) or identical placebo pills (n\u2009=\u200940) for 6 months.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary end point was mean absolute change in hepatic fat content, measured by proton magnetic resonance spectroscopy (MRS) at 6-month follow-up. The 4 key secondary outcomes included mean percentage change in hepatic fat content by MRS, the proportion achieving at least 30% reduction in hepatic fat, and the mean absolute and relative reductions in hepatic fat content, measured by magnetic resonance imaging proton density fat fraction (MRI-PDFF). Analyses adjusted for the baseline value of the corresponding outcome. Minimal clinically important differences for study outcomes were not prespecified.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 80 randomized participants (mean age, 48 years; 44 [55%] women; mean hepatic fat content, 35% [indicating moderate steatosis]), 71 (89%) completed 6-month follow-up. The mean absolute change in hepatic fat content by MRS was \u22126.6% with aspirin vs 3.6% with placebo (difference, \u221210.2% [95% CI, \u221227.7% to \u22122.6%];\n P<\/jats:italic>\n \u2009=\u2009.009). Compared with placebo, aspirin treatment significantly reduced relative hepatic fat content (\u22128.8 vs 30.0 percentage points; mean difference, \u221238.8 percentage points [95% CI, \u221266.7 to \u221210.8];\n P<\/jats:italic>\n \u2009=\u2009.007), increased the proportion of patients with 30% or greater relative reduction in hepatic fat (42.5% vs 12.5%; mean difference, 30.0% [95% CI, 11.6% to 48.4%];\n P<\/jats:italic>\n \u2009=\u2009.006), reduced absolute hepatic fat content by MRI-PDFF (\u22122.7% vs 0.9%; mean difference, \u22123.7% [95% CI, \u22126.1% to \u22121.2%];\n P<\/jats:italic>\n \u2009=\u2009.004]), and reduced relative hepatic fat content by MRI-PDFF (\u221211.7 vs 15.7 percentage points; mean difference, \u221227.3 percentage points [95% CI, \u221245.2 to \u22129.4];\n P<\/jats:italic>\n \u2009=\u2009.003). Thirteen participants (32.5%) in each group experienced an adverse event, most commonly upper respiratory tract infections (10.0% in each group) or arthralgias (5.0% for aspirin vs 7.5% for placebo). One participant randomized to aspirin (2.5%) experienced drug-related heartburn.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this preliminary randomized clinical trial of patients with MASLD, 6 months of daily low-dose aspirin significantly reduced hepatic fat quantity compared with placebo. Further study in a larger sample size is necessary to confirm these findings.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04031729<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2024.1215","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T11:04:34Z","timestamp":1710846274000},"page":"920","source":"Crossref","is-referenced-by-count":101,"title":["Aspirin for Metabolic Dysfunction\u2013Associated Steatotic Liver Disease Without Cirrhosis"],"prefix":"10.1001","volume":"331","author":[{"given":"Tracey G.","family":"Simon","sequence":"first","affiliation":[{"name":"Clinical and Translational Epidemiology Unit (CTEU), Massachusetts General Hospital, Boston"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, 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