The lancet. Gastroenterology & hepatology

Denifanstat for treating fatty liver disease linked to metabolism in a large controlled clinical trial

Updated

Abstract

In a trial of 168 participants, 38% receiving 50 mg of denifanstat daily achieved a significant improvement in liver disease activity compared to 16% in the placebo group.

  • Denifanstat is an oral inhibitor targeting fatty acid synthase, potentially reducing liver inflammation and fibrosis in metabolic dysfunction-associated steatohepatitis (MASH).
  • Participants receiving denifanstat showed a 21% higher risk difference in achieving a 2-point improvement in liver disease activity score without worsening fibrosis compared to placebo.
  • MASH resolution, indicated by a 2-point improvement in liver disease activity without worsening fibrosis, occurred in 26% of the denifanstat group versus 11% in the placebo group.
  • Common side effects included COVID-19, dry eye symptoms, and alopecia, with all reported adverse events being mild (grade 1 or 2) and not serious.
  • No serious adverse events were linked to the treatment, indicating a favorable safety profile for denifanstat.

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Funding

Competing interests

Declaration of interests RL serves as a consultant to Aardvark Therapeutics, Altimmune, Arrowhead Pharmaceuticals, AstraZeneca, Cascade Pharmaceuticals, Eli Lilly, Gilead, Glympse Bio, Inipharma, Intercept, Inventiva, Ionis, Janssen, Lipidio, Madrigal, Neurobo, Novo Nordisk, Merck, Pfizer, Sagimet, 89Bio, Takeda, Terns Pharmaceuticals and Viking Therapeutics. RL has stock options in Sagimet Biosciences. In addition, his institution received research grants from Arrowhead Pharmaceuticals, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galectin Therapeutics, Gilead, Intercept, Hanmi, Inventiva, Ionis, Janssen, Madrigal Pharmaceuticals, Merck, Novo Nordisk, Pfizer, Sonic Incytes, and Terns Pharmaceuticals. He is a co-founder of LipoNexus. RL receives funding support from the National Institute of Diabetes and Digestive and Kidney Diseases (P30DK120515) and the John C Martin Foundation (RP124). KG, EBM, GK, MO'F, WM, and W-WT are current or former employees of Sagimet Biosciences and own or have options to purchase stock in the company. EL is a researcher for 89Bio, Akero Therapeutics, Alnylam Pharmaceuticals, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, DSM, Eli Lilly, Enanta Pharmaceuticals, Enyo Pharma, Exalenz Bioscience, Galectin Therapeutics, Galmed Pharmaceuticals, Genfit, Gilead Sciences, GSK, Hanmi Pharmaceuticals, Hightide Biopharma, Intercept Pharmaceuticals, Inventiva, Janssen Pharmaceuticals, Madrigal Pharmaceuticals, Merck & Co, NGM Biopharmaceuticals, Northsea Therapeutics, Novartis, Novo Nordisk, Poxel, Sagimet Biosciences, Takeda, Terns Pharmaceuticals, Viking Therapeutics, and Zydus Pharmaceuticals. SAH was a scientific advisor or consultant for Akero, Aligos, Altimmune, Arrowhead, Auransa, Echosens, Galecto, Gilead, GSK, Hepion, Hepta Bio, HistoIndex, Humana, Inventiva, Kriya, Madrigal, Medpace, Merck, NeuroBo, Northsea, Novo Nordisk, Perspectum, Pfizer, Seal Rock, Sonic Incytes, Sagimet, Terns, and Viking. They received grant or research support from Akero, Altimmune, Axcella, BMS, Corcept, Cymabay, Enyo, Galectin, Genentech, Genfit, Gilead, GSK, Hepion, Hightide, Immuron, Intercept, Inventiva, Ionis, Madrigal, NGM Bio, Novartis, Novo Nordisk, Northsea, Pfizer, Poxel, Sagimet, Terns, and Viking. All other authors declare no competing interests.
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