Aspirin Shows Promise In Treating Common Liver Disease

Daily, low-dose aspirin may be an effective treatment for a common type of liver disease, according to a new study.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by fat buildup in the liver, affecting its function. Also called non-alcoholic fatty liver disease, it is commonly associated with factors such as type 2 diabetes and obesity, but is not related to alcohol consumption.

Up to a third of Americans have fat build up in the liver and in about 2-5% that fat build up has already caused inflammation and liver cell damage. Although symptoms can take years to develop after the initial fat build-up, with fatty liver disease sometimes being called "silent," they include fatigue, weight loss, weakness, itching and yellowing of the skin or eyes. Permanent, irreversible liver damage called cirrhosis can result and people who are badly affected may develop liver failure where the only suitable treatment is a transplant.

Once fat buildup in the liver has begun to damage the organ, no approved treatments are available to reverse it, but some lifestyle changes such as lowering cholesterol, losing weight and medication to control blood pressure and diabetes may be effective.

Now a new clinical trial led by researchers at Harvard has tested whether low-dose daily aspirin might be an effective treatment for fat build up in the liver.

“Since MASLD is estimated to affect up to a third of U.S. adults, aspirin represents an attractive potential low-cost option to prevent progression to cirrhosis or liver cancer, the most feared complications of MASLD,” said Andrew T. Chan, lead author of the work and a gastroenterologist and professor at Harvard Medical School in Boston, MA.

The study, published in the Journal of the American Medical Association involved 80 people with MASLD who were split equally into those who received the daily aspirin and those who received a placebo instead. The participants were aged between 18 and 70 years old and did not know whether they were getting the real drug or not. At the beginning of the trial and 6 months after the aspirin, or placebo, the participants had their quantity of liver fat measured. Participants who had received the aspirin had their liver fat reduce by 6.6% on average, whereas those who received the placebo had an increase of 3.6% on average. Other tests of liver function also showed improvement in people who had received the aspirin.

“Multiple noninvasive blood and imaging-based tests for liver fat, inflammation, and fibrosis all showed a similar direction of benefit that favored aspirin treatment,” said Tracey G. Simon, hepatologist and instructor at Harvard Medical School who was lead author of the work. “Together, these data support the potential for aspirin to provide benefits for patients with MASLD," added Simon.

The researchers think aspirin works to reduce liver fat by decreasing inflammation and also affecting fat metabolism. However, they stress that further studies are needed to determine whether the result holds up in a larger number of people and also whether the benefits of aspirin use on liver fat persist long term.