{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:56:34Z","timestamp":1791831394030,"version":"4.3.4"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n Fenofibrate forms the standard of care for managing hypertriglyceridemia. Many of these patients have associated metabolic dysfunction-associated steatotic liver disease (MASLD). No systematic review and meta-analysis (SRM) has analysed the impact of fenofibrate in MASLD. Hence, we undertook this SRM.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Electronic databases were searched for randomised controlled trials (RCTs) involving MASLD patients receiving fenofibrate as an intervention and placebo\/active comparator as control. The primary outcome was changes in alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Secondary outcomes were alterations in liver fat (ultrasonography or magnetic resonance imaging), lipid parameters, and adverse events.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n From initially screened 395 articles, data from 5 RCTs were analysed. Fenofibrate had comparable changes in ALT (mean difference [MD]-0.32 IU\/L [95% confidence interval [CI]: \u22126.70\u20137.33];\n P<\/jats:italic>\n = 0.931;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 60%) and AST (MD-0.17 IU\/L [95% CI: \u22123.83\u20133.48];\n P<\/jats:italic>\n = 0.932;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 31%) as compared to active controls (atorvastatin, omega-3 fatty acids [O3FA] and pioglitazone). Fenofibrate users had a greater increase in liver-fat content as compared to active controls (pioglitazone and O3FA) (MD 5.37 [95% CI: 0.30\u201310.44];\n P<\/jats:italic>\n = 0.041;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 85%). O3FA and pioglitazone use is associated with reduction in liver fat, which explains the apparent increase in liver fat with fenofibrate in our analysis. Fenofibrate was associated with a significantly greater decrease in triglycerides compared to active controls (MD-0.22 mmol\/l [95% CI: \u22120.31\u2013\u22120.12];\n P<\/jats:italic>\n < 0.001;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 0%). Fenofibrate was associated with comparable change in total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, weight, and waist circumference compared to active controls.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This SRM provides us with reassuring safety data on use of fenofibrate in MASLD. Fenofibrate is largely MASLD neutral and continues to have good triglyceride lowering properties in MASLD.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijem.ijem_528_24","type":"journal-article","created":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T12:00:34Z","timestamp":1751112034000},"page":"268-275","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Fenofibrate in Metabolic Dysfunction-associated Steatotic Liver Disease: A Systematic Review and Meta-analysis"],"prefix":"10.4103","volume":"29","author":[{"given":"Manoj","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Maharishi Markandeshwar Institute of Medical Sciences, Ambala, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avivar","family":"Awasthi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, MAHE, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deep","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Center for Endocrinology Diabetes Arthritis and Rheumatism Superspeciality Healthcare, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameya","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Bhaktivedanta Hospitals, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Center for Endocrinology Diabetes Arthritis and Rheumatism Superspeciality Healthcare, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,28]]},"reference":[{"key":"R1-20250628","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s40265-024-02015-6","article-title":"Comparative efficacy of drug interventions on NAFLD Over 24 Weeks: A traditional and network meta-analysis of randomized controlled trials","volume":"84","author":"Wang","year":"2024","journal-title":"Drugs"},{"key":"R2-20250628","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.ecl.2023.01.003","article-title":"Lipid disorders and metabolic-associated fatty liver disease","volume":"52","author":"Anwar","year":"2023","journal-title":"Endocrinol Metab Clin North Am"},{"key":"R3-20250628","doi-asserted-by":"crossref","first-page":"470","DOI":"10.4254\/wjh.v5.i9.470","article-title":"Current role of fenofibrate in the prevention and management of non-alcoholic fatty liver disease","volume":"5","author":"Kostapanos","year":"2013","journal-title":"World J Hepatol"},{"key":"R4-20250628","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.clinre.2015.02.011","article-title":"Fenofibrate is effective adjunctive therapy in the treatment of primary biliary cirrhosis: A meta-analysis","volume":"39","author":"Grigorian","year":"2015","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"R5-20250628","first-page":"2757","article-title":"Combination therapy of fenofibrate and ursodeoxycholic acid in patients with primary biliary cirrhosis who respond incompletely to UDCA monotherapy: A meta-analysis","volume":"9","author":"Zhang","year":"2015","journal-title":"Drug Des Devel Ther"},{"key":"R6-20250628","first-page":"242","article-title":"Efficacy and safety of fenofibrate in combination with phototherapy for the treatment of neonatal hyperbilirubinemia: A systematic review and meta-analyses","volume":"102","author":"Abdellatif","year":"2024","journal-title":"Can J Physiol Pharmacol"},{"key":"R7-20250628","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.eprac.2024.04.016","article-title":"Role of resmetirom, a liver-directed, thyroid hormone receptor beta-selective agonist, in managing nonalcoholic steatohepatitis: A systematic review and meta-analysis","volume":"30","author":"Dutta","year":"2024","journal-title":"Endocr Pract"},{"key":"R8-20250628","first-page":"1111430","article-title":"Response to pioglitazone in non-alcoholic fatty liver disease patients with vs","volume":"14","author":"Wang","year":"2023","journal-title":"without type 2 diabetes: A meta-analysis of randomized controlled trials. 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